Optimal Management of Malignant Polyps, From Endoscopic Assessment and Resection to Decisions About Surgery.
Colon Polyp
Colorectal Cancer
Malignant Polyps
Journal
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
28
06
2018
revised:
28
08
2018
accepted:
16
09
2018
pubmed:
1
10
2018
medline:
22
10
2020
entrez:
1
10
2018
Statut:
ppublish
Résumé
Colorectal cancer is defined clinically as invasion of dysplastic cells into the submucosa. Lesions with submucosal invasion but without invasion into the muscularis propria are generally called malignant polyps. A stepwise approach produces optimal management of malignant polyps (including polypoid and flat/depressed lesions). The first step is to avoid endoscopic resection of non-pedunculated lesions with endoscopic features that predict deep submucosal invasion. Lesions without such features are candidates for endoscopic resection. The second step is to assess candidates for endoscopic resection for features that predict an increased risk of superficial submucosal invasion. Such lesions should be considered for en bloc endoscopic excision if feasible. The third step is giving patients with endoscopically resected malignant polyps good advice regarding whether to undergo adjuvant therapy, usually surgery. We review the endoscopic and histologic criteria that guide clinicians through these steps.
Identifiants
pubmed: 30268567
pii: S1542-3565(18)31072-3
doi: 10.1016/j.cgh.2018.09.040
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1428-1437Informations de copyright
Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.