Variations in the management of significant polyps and early colorectal cancer: results from a multicentre observational study of 383 patients

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
M DattaniSPECC study group

Abstract

The concept of significant polyps and early colorectal cancer (SPECC) encompasses complex polyps not amenable to routine snare polypectomy or where malignancy cannot be excluded. Surgical resection (SR) offers definitive treatment, but is overtreatment for the majority which are benign and amenable to less invasive endoscopic resection (ER). The aim of this study was to investigate variations in the management and outcomes of significant colorectal polyps. This was a retrospective observational study of significant colorectal polyps, defined as nonpedunculated lesions of ≥ 20 mm size, diagnosed across nine UK hospitals in 2014. Inclusion criteria were endoscopically or histologically benign polyps at biopsy. A total of 383 patients were treated by primary ER (87.2%) or SR (12.8%). Overall, 108/383 (28%) polyps were detected in the Bowel Cancer Screening Programme (BCSP). Primary SR was associated with a significantly longer length of stay and major complications (P < 0.01). Of the ER polyps, 290/334 (86.8%) patients were treated without undergoing surgery. The commonest indication for secondary surgery was unexpected polyp cancer, and of these cases 60% had no residual cancer in the specimen. Incidence of unexpected cancer was ...Continue Reading

References

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Citations

Nov 20, 2018·Acta Oncologica·Brendan J Moran
Feb 28, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·M Dattani, B J Moran
Feb 28, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·F Di Fabio, B J Moran
Jun 28, 2019·Current Opinion in Gastroenterology·Ignasi PuigMarco Bustamante
Jun 9, 2020·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Thomas GrainvilleAstrid Lièvre
Sep 3, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Jody ParkerSunil Dolwani

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