The occurrence and characteristics of endoscopically unexpected malignant degeneration in large rectal adenomas

Autor: Annekatrien C.T.M. Depla, Albert Wolthuis, Bart Bijnen, Hendrik M. van Dullemen, A.W. Marc van Milligen de Wit, Frank J.C. van den Broek, M. H. M. G. Houben, Willem A. Bemelman, Matthijs P. Schwartz, Bas L. Weusten, Ignace H. J. T. de Hingh, Rosalie C. Mallant, Renée M. Barendse, Jeroen M. Jansen, Esther C. J. Consten, Paul Fockens, George P. van der Schelling, Eelco J. R. de Graaf, Evelien Dekker, Maxime E. S. Bronzwaer, Robin Timmer, Chrisiaan Hoff, Pascal G. Doornebosch, Michael F. Gerhards, Paul H. P. Davids, Ben J.M. Witteman, Pieter J. Tanis, James C. H. Hardwick, Raf Bisschops, Lianne Koens, Gijsbert D. Musters, Erik J. Schoon, Klaas van der Linde
Přispěvatelé: Bisschops, Raf, CCA - Cancer Treatment and quality of life, Graduate School, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Pathology, APH - Quality of Care, Gastroenterology and Hepatology
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Endoscopic ultrasound
Male
Transanal Endoscopic Microsurgery
Colorectal cancer
MUCOSAL RESECTION
Endoscopic mucosal resection
Proctoscopy
COLORECTAL-CANCER
0302 clinical medicine
LOCAL EXCISION
MICROSURGERY
Medicine
Incidental Findings
OUTCOMES
medicine.diagnostic_test
Gastroenterology
Intestinal Polyps
Middle Aged
EUROPEAN-SOCIETY
030220 oncology & carcinogenesis
BIOPSY
030211 gastroenterology & hepatology
Female
Radiology
Life Sciences & Biomedicine
Adenoma
NEOPLASTIC LESIONS
medicine.medical_specialty
Endoscopic Mucosal Resection
Argon plasma coagulation
Malignancy
DIAGNOSIS
03 medical and health sciences
Humans
Radiology
Nuclear Medicine and imaging
Rectal Polyp
Aged
Science & Technology
Gastroenterology & Hepatology
business.industry
Rectal Neoplasms
Rectum
medicine.disease
Surgery
Dysplasia
RISK-FACTORS
business
Precancerous Conditions
Follow-Up Studies
Zdroj: Gastrointestinal Endoscopy, 87(3), 688-694.e2. Mosby Inc.
Gastrointestinal endoscopy, 87(3), 862-871.e1. Mosby Inc.
ISSN: 0016-5107
Popis: Background and Aims: Large non-pedunculated rectal polyps are most commonly resected by endoscopic mucosal resection (EMR) or transanal endoscopic microsurgery (TEM). Despite pre-procedural diagnostics, unexpected rectal cancer is incidentally encountered within the resected specimen. This study aimed to compare the diagnostic assessment and procedural characteristics of lesions with and without unexpected submucosal invasion. Methods: A post-hoc analysis of a multicenter randomized trial (TREND study) was performed in which patients with a non-pedunculated rectal polyp of >= 3 cm without endoscopic suspicion of invasive growth were randomized between EMR and TEM. Results: Unexpected rectal cancer was detected in 13% (27/203) of patients; 15 after EMR and 12 after TEM. Most consisted of low-risk T1 cancers (78%, n = 18). There were no differences in the diagnostic assessment between lesions with and without unexpected submucosal invasion. Diagnostic biopsies revealed similar rates of high-grade dysplasia (28%[7/25] vs 18% [26/144]). When compared with EMR of adenomas, EMR procedures of unexpected cancers had a lower success rate of submucosal lifting (60% vs 93%, P
Databáze: OpenAIRE
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