Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps
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...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2023-06-01
|
| Series: | Journal of Coloproctology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1769922 |
| _version_ | 1827917964220825600 |
|---|---|
| author | Amr Ibrahim Loay M. Gertallah Mahmoud Abdelaziz Rehab Hemeda Ahmed Fathy Gomaa Mahmoud Ghoneme Mahmoud Sherbeiny Ahmed Lotfy Sharaf Ola A. Harb Mohamed Farouk Amin |
| author_facet | Amr Ibrahim Loay M. Gertallah Mahmoud Abdelaziz Rehab Hemeda Ahmed Fathy Gomaa Mahmoud Ghoneme Mahmoud Sherbeiny Ahmed Lotfy Sharaf Ola A. Harb Mohamed Farouk Amin |
| author_sort | Amr Ibrahim |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T03:35:58Z |
| format | Article |
| id | doaj.art-f1d41a9ac2f1494a99a38173e7560dad |
| institution | Directory Open Access Journal |
| issn | 2237-9363 2317-6423 |
| language | English |
| last_indexed | 2024-03-13T03:35:58Z |
| publishDate | 2023-06-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Journal of Coloproctology |
| spelling | doaj.art-f1d41a9ac2f1494a99a38173e7560dad2023-06-23T22:50:27ZengThieme Revinter Publicações Ltda.Journal of Coloproctology2237-93632317-64232023-06-01430212613210.1055/s-0043-1769922Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon PolypsAmr Ibrahim0Loay M. Gertallah1Mahmoud Abdelaziz2Rehab Hemeda3Ahmed Fathy Gomaa4Mahmoud Ghoneme5Mahmoud Sherbeiny6Ahmed Lotfy Sharaf7Ola A. Harb8Mohamed Farouk Amin9Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of Surgical Oncology, Oncology Center, Mansura University, Mansoura, EgyptDepartment of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of Hepatogastroenterology and Infectious Diseases Faculty of Medicine, Alazhar University, Cairo, EgyptDepartment of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Giza, EgyptDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of Pathology, Faculty of Medicine, Zagazig University, Zagazig, EgyptDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, EgyptBackground 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1769922malignant colon polypssurgical resectionpolypectomysurvival |
| spellingShingle | Amr Ibrahim Loay M. Gertallah Mahmoud Abdelaziz Rehab Hemeda Ahmed Fathy Gomaa Mahmoud Ghoneme Mahmoud Sherbeiny Ahmed Lotfy Sharaf Ola A. Harb Mohamed Farouk Amin Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps Journal of Coloproctology malignant colon polyps surgical resection polypectomy survival |
| title | Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps |
| title_full | Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps |
| title_fullStr | Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps |
| title_full_unstemmed | Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps |
| title_short | Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps |
| title_sort | prognostic roles and survival benefits of endoscopic resection versus surgical resection in the management of malignant colon polyps |
| topic | malignant colon polyps surgical resection polypectomy survival |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1769922 |
| work_keys_str_mv | AT amribrahim prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT loaymgertallah prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT mahmoudabdelaziz prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT rehabhemeda prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT ahmedfathygomaa prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT mahmoudghoneme prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT mahmoudsherbeiny prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT ahmedlotfysharaf prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT olaaharb prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps AT mohamedfaroukamin prognosticrolesandsurvivalbenefitsofendoscopicresectionversussurgicalresectioninthemanagementofmalignantcolonpolyps |