International validation of a risk prediction algorithm for patients with malignant colorectal polyps.
Colorectal
cancer
malignant
polyp
treatment
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
12
07
2020
accepted:
31
08
2020
pubmed:
16
9
2020
medline:
19
8
2021
entrez:
15
9
2020
Statut:
ppublish
Résumé
The optimal management strategy for patients with endoscopically resected malignant colorectal polyps (MCP) has yet to be defined. The aim of this study was to validate a published decision-making tool, termed the Scottish Polyp Cancer Study (SPOCS) algorithm, on a large international population. The SPOCS algorithm allocates patients to risk groups based on just two variables: the polyp resection margin and the presence of lymphovascular invasion (LVI). The risk groups are termed low (clear margin, LVI absent), medium (clear margin, LVI present) or high (involved/non-assessable margin). The International Polyp Cancer Collaborative was formed to validate the algorithm on data from Australia, Denmark, UK and New Zealand. In total, 1423 patients were included in the final dataset. 680/1423 (47.8%) underwent surgical resection and 108/680 (15.9%) had residual disease (luminal disease 8.8%, lymph node metastases 8.8%). The SPOCS algorithm classified 602 patients as low risk (in which 1.5% had residual disease), 198 patients as medium risk (in which 7.1% had residual disease) and 484 as high risk (in which 14.5% had residual disease) (P < 0.001, χ The SPOCS algorithm can be used to predict the risk of residual disease in patients with endoscopically resected MCPs. Surgery can be safely avoided in patients who have a clear margin of excision and no evidence of LVI.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2105-2113Informations de copyright
© 2020 The Association of Coloproctology of Great Britain and Ireland.
Références
Benizri EI, Bereder JM, Rahili A et al. Additional colectomy after colonoscopic polypectomy for T1 colon cancer: a fine balance between oncologic benefit and operative risk. Int J Colorectal Dis 2012; 27: 1473-8. PMID: 22454048.
Williams JG, Pullan RD, Hill J et al. Management of the malignant colorectal polyp: ACPGBI position statement. Colorectal Dis 2013; 15: 1-38.
Barclay K, Leggett B, Macrae F et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. https://wiki.cancer.org.au/australia/Guidelines:Colorectal_cancer/Colonoscopy_surveillance/Malignant_polyps (accessed March 2020).
Luzietti E, Pellino G, Nikolaou S et al. Comparison of guidelines for the management of rectal cancer. BJS Open 2018; 2: 433-51. eCollection 2018 Dec. PubMed PMID: 30511044; PubMed Central PMCID: PMC6254003. good for comparing management of polyp cancers between countries.
Watanabe T, Muro K, Ajioka Y et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol 2018; 23: 1-34.
Haggitt RC, Glotzbach RE, Soffer EE et al. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985; 89: 328-36.
Kikuchi R, Takano M, Takagi K et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum 1995; 38: 1286-95.
West NP, Langman G, Haboubi N et al. Significant polyps and early colorectal cancer: the importance of high-quality standardized histopathology. Colorectal Dis. 2019; 21: 53-6. PubMed PMID: 30809908.
Loughrey MB, Quirke P, Shepherd NA. Dataset for histopathological reporting of colorectal cancer. 4th edition. London: Royal College of Pathologists, 2018.
Cooper GS, Xu F, Barnholtz Sloan JS et al. Management of malignant colonic polyps: a population-based analysis of colonoscopic polypectomy versus surgery. Cancer 2012; 118: 651-9. Epub 2011 Jul 12. PubMed PMID: 21751204; PubMed Central PMCID: PMC3193545.
Gill MD, Rutter MD, Holtham SJ. Management and short-term outcome of malignant colorectal polyps in the north of England (1). Colorectal Dis 2013; 15: 169-76.
Richards CH, Ventham NT, Mansouri D et al. An evidence-based treatment algorithm for colorectal polyp cancers: results from the Scottish Screen-detected Polyp Cancer Study (SSPoCS). Gut 2018; 67: 299-306. Epub 2016 Oct 27.
Brown IS, Bettington ML, Bettington A et al. Adverse histological features in malignant colorectal polyps: a contemporary series of 239 cases. J Clin Pathol 2016; 69: 292-9.
Fischer J, Dobbs B, Dixon L et al. Management of malignant colorectal polyps in New Zealand. ANZ J Surg 2017; 87: 350-5. Epub 2016 Apr 8. PubMed PMID: 27062541.
Levic K, Bulut O, Hansen TP et al. Malignant colorectal polyps: endoscopic polypectomy and watchful waiting is not inferior to subsequent bowel resection. A nationwide propensity score-based analysis. Langenbecks Arch Surg 2019; 404: 231-42. [Epub ahead of print].
Richards C, Kumarasinghe P, Hessamodini H et al. Revising the definition of vertical margin involvement following endoscopic polypectomy may reduce unnecessary surgery in patients with malignant colorectal polyps. JGH Open 2020; 4: 387-93.
Wasif N, Etzioni D, Maggard MA et al. Trends, patterns, and outcomes in the management of malignant colonic polyps in the general population of the United States. Cancer 2011; 117: 931-7. Epub 2010 Oct 19 PubMed PMID: 20960490.
Bujanda L, Cosme A, Gil I et al. Malignant colorectal polyps. World J Gastroenterol 2010; 16: 3103-11. PubMed PMID: 20593495; PubMed Central PMCID: PMC2896747.
Logan RF, Patnick J, Nickerson C et al. English Bowel Cancer Screening Evaluation Committee. Outcomes of the Bowel Cancer Screening Programme (BCSP) in England after the first 1 million tests. Gut. 2012; 61: 1439-46. Epub 2011 Dec 7. PubMed PMID: 22156981; PubMed Central PMCID:PMC3437782.
Ueno H, Mochizuki H, Hashiguchi Y et al. Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology 2004; 127: 385-94.
Gollins S, Moran B, Adams R et al. Association of Coloproctology of Great Britain & Ireland (ACPGBI): guidelines for the management of cancer of the colon, rectum and anus (2017) - multidisciplinary management. Colorectal Dis 2017; 19: 37-66. PubMed PMID: 28632307.
Rickert A, Aliyev R, Belle S et al. Oncologic colorectal resection after endoscopic treatment of malignant polyps: does endoscopy have an adverse effect on oncologic and surgical outcomes? Gastrointest Endosc 2014; 79: 951-60. Epub 2014 Jan 9.
Bach SP, Hill J, Monson JR et al. Association of Coloproctology of Great Britain and Ireland Transanal Endoscopic Microsurgery (TEM) Collaboration. A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer. Br J Surg. 2009; 96: 280-90. PubMed PMID: 19224520.
Toh EW, Brown P, Morris E et al. Area of submucosal invasion and width of invasion predicts lymph node metastasis in pT1 colorectal cancers. Dis Colon Rectum 2015; 58: 393-400. PubMed PMID: 25751795.
Cappellesso R, Luchini C, Veronese N et al. Tumor budding as a risk factor for nodal metastasis in pT1 colorectal cancers: a meta-analysis. Hum Pathol. 2017; 65: 62-70. Epub 2017 Apr 22. Review PubMed PMID: 28438617.
Weinberg RA. Mechanisms of malignant progression. Carcinogenesis 2008; 29: 1092-5. Epub 2008 May 2. Review. PubMed PMID: 18453542; PubMed Central PMCID: PMC2902402.
Gervasoni JE Jr, Sbayi S, Cady B. Role of lymphadenectomy in surgical treatment of solid tumors: an update on the clinical data. Ann Surg Oncol. 2007; 14: 2443-62. Epub 2007 Jun 28. Review.
Naxerova K, Reiter JG, Brachtel E et al. Origins of lymphatic and distant metastases in human colorectal cancer. Science 2017; 357: 55-60. PubMed PMID: 28684519; PubMedCentral PMCID: PMC5536201.
McClelland D, Murray GI. A comprehensive study of extramural venous invasion in colorectal cancer. PLoS One 2015; 10: e0144987. eCollection 2015. PubMed PMID: 26671331; PubMedCentral PMCID: PMC4682925.