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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(02): 126-132
DOI: 10.1055/s-0043-1769922
Original Article

Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps

Autoren

  • Amr Ibrahim

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Loay M. Gertallah

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Mahmoud Abdelaziz

    2   Department of Surgical Oncology, Oncology Center, Mansura University, Mansoura, Egypt

  • Rehab Hemeda

    3   Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Ahmed Fathy Gomaa

    4   Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Mahmoud Ghoneme

    5   Department of Hepatogastroenterology and Infectious Diseases Faculty of Medicine, Alazhar University, Cairo, Egypt

  • Mahmoud Sherbeiny

    6   Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Giza, Egypt

  • Ahmed Lotfy Sharaf

    7   Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Ola A. Harb 

    8   Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

  • Mohamed Farouk Amin

    1   Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Abstract

Background Due to few sufficient data regarding the comparison between endoscopic and surgical resection of malignant colorectal polyps regarding outcomes and survival benefits, there are no clear guidelines of management strategies of malignant colorectal polyps.

The aims of the present study were to compare endoscopic resection alone and surgical resection in patients with malignant polyps in the colon (T1N0M0) readings advantages, disadvantages, recurrence risks, survival benefits, and long-term prognosis to detect how management strategy affects outcome.

Patients and methods we included 350 patients. All included patients were divided into 2 groups; the first group included 100 patients who underwent only endoscopic polypectomy and the second group included 250 patients who underwent endoscopic polypectomy followed by definitive surgical resection after histopathological diagnosis.

We followed all patients for about 5 years, ranging from 18 to 55 months.

The primarily evaluated parameters are surgical consequences and patients' morbidity. The secondary evaluated parameters are recurrence risks, recurrence free survival, and overall survival rates.

Results The age of patients who underwent polypectomy is usually younger than the surgical group, males have more liability to polypectomy in comparison with females.

Patients with tumors in the left colon have more liability to polypectomy in comparison with the right colon (p < 0.0001). Tumor factors associated with more liability to surgical resection are presence of lymphovascular invasion, high grade, and poor tumor differentiation (p < 0.0001).

The management strategy was the most significant predictor of overall and recurrence free survival rates in patients with malignant colon polyps (p < 0.001).

Conclusions We found that survival benefits and lower incidence of recurrence are detected in the surgical resection group more than in the polypectomy group.

Keywords

malignant colon polyps - surgical resection - polypectomy - survival


Publikationsverlauf

Eingereicht: 16. Februar 2023

Angenommen: 19. April 2023

Artikel online veröffentlicht:
23. Juni 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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