Posted by Medivizor on Apr 10, 2013 in Colorectal cancer |
In a nutshell
The present study evaluated factors associated with residual or recurrent disease in patients with colorectal adenocarcinomas developed from adenomas initially treated endoscopically.
Some background
A colorectal adenoma is a benign (non-cancerous) abnormal growth in the inner lining of the large intestine (colon and rectum) also called an adenomatous polyp. Most colorectal cancers develop from adenomatous polyps. Cancer that originates in adenomas is called adenocarcinoma. The only way to know if a polyp is cancerous or not is to remove it completely, or to collect a part of it (biopsy) to be analyzed by a pathologist. Removal of a polyp can be done either surgically, by removing a part of the large bowel that contains the polyp (a procedure called a 'partial colectomy'), or during a colonoscopy, by cutting the polyp (referred to as a 'polypectomy'). A colonoscopy is a procedure doctors use to look inside the large bowel using a thin flexible tube with a camera (colonoscope). Usually, the doctor guides the colonoscope into the large intestine, from the rectum to the small bowel (complete colonoscopy).
When a polyp is removed, there are certain factors that can be associated with residual (remaining) cancer and the risk of recurrence (return of the cancer). These criteria include how deep the cancer has invaded the bowel, cancer invasion in the surrounding lymph nodes, how aggressive the cancer is (high or low risk) and if the remaining bowel has been affected by the cancer (if a complete resection was achieved). Certain proteins found in the cancer may also be used to predict recurrences. The risk of recurrence is assesed by the pathologist who examines the biopsy sample.
Methods & findings
This study included 151 patients with colorectal adenocarcinomas that originated in adenomas initially treated by endoscopy. 47% of patients required surgery to make sure the cancer was completely removed. After a median follow-up of 44 months, residual or recurrent cancer was found in 17 patients (11.2%). When analyzed by a pathologist, no specific proteins in the cancer were found to predict residual or recurrent disease. Still, patients who had incomplete colonoscopies or incomplete resection of the cancer, as well as patients who had more aggressive cancers (high risk) were found to have a greater risk of residual or recurrent cancer.
The bottom line
In conclusion, specific proteins in the cancer did not predict the risk for cancer recurrence in this study. Only incomplete colonoscopy, incomplete resection and high risk cancer types were associated with an important risk of cancer persistence of reoccurrence.
The fine print
However, this study looks back at patients who have been treated in the past (retrospective study) rather than following the patients throughout their treatment and determining their outcomes (prospective study). Retrospective studies are considered to provide weak statistical evidence. Also, the study included patients treated over a decade (1999-2009), during which endoscopic resection methods have improved.
Published By :
Colorectal Disease
Original Title :
Immunohistochemical alterations in invasive adenocarcinoma in endoscopically resected adenoma and factors associated with risk of residual or recurrent disease
Tags:
Confined or spread disease-Confined only to the colon, rectum or appendix,
Current stage-Stage 0,
Current treatment status-Did not start treatment yet,
Current treatment status-Not currently treated,
Library Item,
Performance status-2 - Symptomatic, 50 in bed,
Research,
Type(s) of colorectal cancer (CRC)-Adenocarcinoma of the appendix,
Type(s) of colorectal cancer (CRC)-Malignant polyp of colon,
Type(s) of colorectal cancer (CRC)?-Adenocarcinoma of the colon
