relation: http://publicatio.bibl.u-szeged.hu/31339/
title: Long-term outcomes after endoscopic removal of malignant colorectal polyps : Results from a 10-year cohort
creator:  Fábián Anna
creator:  Bor Renáta
creator:  Vasas Béla
creator:  Szűcs Mónika
creator:  Tóth Tibor
creator:  Bősze Zsófia
creator:  Szántó Kata Judit
creator:  Bacsur Péter
creator:  Bálint Anita
creator:  Farkas Bernadett
creator:  Farkas Klaudia
creator:  Milassin Ágnes
creator:  Rutka Mariann
creator:  Resál Tamás
creator:  Molnár Tamás
creator:  Szepes Zoltán
subject: 03.02.19. Gasztroenterológia és hepatológia
subject: 03.02.21. Onkológia
description: Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging, and evidence regarding a surveillance-only strategy is limited.To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020. Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were investigated. Event rates for categorical variables and means for continuous variables with 95% confidence intervals were calculated, and Fisher's exact test and Mann-Whitney test were performed. Potential risk factors of adverse outcomes were determined with univariate and multivariate logistic regression models.In total, 135 lesions (mean size: 22.1 mm; location: 42% rectal) from 129 patients (mean age: 67.7 years; 56% male) were enrolled. The proportion of pedunculated and non-pedunculated lesions was similar, with en bloc resection in 82% and 47% of lesions, respectively. Tumor differentiation, distance from resection margins, depth of submucosal invasion, lymphovascular invasion, and budding were reported at 89.6%, 45.2%, 58.5%, 31.9%, and 25.2%, respectively. Residual tumor was found in 10 patients, and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection. Univariate analysis identified piecemeal resection as a risk factor for residual malignancy (odds ratio: 1.74; P = 0.042). At least 1 year of follow-up was available for 117 lesions from 111 patients (mean follow-up period: 5.59 years). Overall, 54%, 30%, 30%, 11%, and 16% of patients presented at the 1-year, 3-year, 5-year, 7-year, and 9-10-year surveillance examinations. Adverse outcomes occurred in 9.0% (local recurrence and dissemination in 4 patients and 9 patients, respectively), with no difference between patients undergoing secondary surgery and surveillance only.Reporting of histological features and adherence to surveillance colonoscopy needs improvement. Long-term adverse outcome rates might be higher than previously reported, irrespective of whether secondary surgery was performed.
date: 2024
type: Folyóiratcikk
type: PeerReviewed
format: text
identifier: http://publicatio.bibl.u-szeged.hu/31339/1/WJGE-16-193-with-cover.pdf
identifier:     Fábián Anna;  Bor Renáta;  Vasas Béla;  Szűcs Mónika;  Tóth Tibor;  Bősze Zsófia;  Szántó Kata Judit;  Bacsur Péter;  Bálint Anita;  Farkas Bernadett;  Farkas Klaudia;  Milassin Ágnes;  Rutka Mariann;  Resál Tamás;  Molnár Tamás;  Szepes Zoltán: Long-term outcomes after endoscopic removal of malignant colorectal polyps : Results from a 10-year cohort.   WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY, 16 (4).  pp. 193-205.  ISSN 1948-5190 (2024)     
identifier: doi:10.4253/wjge.v16.i4.193
relation: https://doi.org/10.4253/wjge.v16.i4.193
relation: 34852892
language: eng