The Malignant Polyp - When to Operate: The St. Mark’s Experience
The world literature on malignant polyps suggests that those removed endoscopically with recognized favorable histological features for conservative management have excellent prognoses without surgery. Many sessile or 'uncertainly removed' malignant polyps after endoscopic polypectomy also...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
1990-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/1990/627894 |
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| Summary: | The world literature on malignant polyps suggests that those
removed endoscopically with recognized favorable histological features for conservative
management have excellent prognoses without surgery. Many sessile
or 'uncertainly removed' malignant polyps after endoscopic polypectomy also
show no evidence of residual cancer, suggesting that referral for surgical resection
is not invariably in the best interests of elderly or poor surgical risk patients. St
Mark's experience of five year follow-up of 62 patients with malignant polyps
judged 'completely excised' showed three cancer-related deaths (of uncertain
primary) in 78- to 81-year-old patients. Of 18 patients with malignant polyps
'incompletely excised,' seven had no cancer found at surgery, 10 were well
without surgery and one died from carcinomatosis following delayed surgery.
These generally encouraging results are further evidence that 'knee jerk surgery'
for malignant polyps is inappropriate. |
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| ISSN: | 0835-7900 |