Coloscopic polypectomy in diagnosis and management of cancerous adenomas: an individual and multicentric experience.
Of 1696 endoscopically removed polyps in the authors' series 62% were adenomas and 31 showed invasive carcinoma. 8 patients were not available for follow-up, and 7 underwent surgical resection with negative findings. There was no evidence of recurrent cancer in the remaining 16 over a 1-6 year span of follow-up, although one unrelated rectal carcinoma and an adenoma were found. By combining the data of 10 Italian Centres, 44 further patients were available, who had had endoscopic polypectomy as the only management of cancerous adenomas, adding no additional example of recurrent carcinoma. It is concluded that endoscopic polypectomy can, providing strict histological criteria are satisfied, provide definitive resection of some cancerous adenomas. A detailed follow-up regime including physical examination, occult blood testing, repeated endoscopy, paired tumour antigen levels and ultrasonography has been used to confirm the absence of recurrence in our series.