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 Printable version |
Management of malignant colorectal polyps |
Hépato-Gastro. Volume 18, Number 5, 486-91, Septembre-Octobre 2011, Séminaire SNFGE 2011
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 Résumé
Article gratuit
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Author(s) : Jean-Christophe Saurin, Marielle Guillet, Denis Heresbach, Bruno Vedrenne, Valérie Hervieux, René Laugier, Thierry Ponchon |
Summary : Following endoscopic resection of a cancerous polyp, there is no surgical indication for one-piece intra-mucosal cancer. In the situation of sub-mucosal infiltrating cancer, four major histologic criteria are in favour of complementary surgery, whenever the patient's status allows this option: the presence of lymphatic or vascular invasion, a grade III histology and the absence of at least 1 mm clear margin. One additional important criterion is a sub-mucosal infiltration deeper than 1 000
μM. The validated one is the “budding” criteria (isolated or undifferentiated or aggressive tumor cell foci at the tumor margin). Without negative criteria, the endoscopic treatment can be considered as satisfying on a carcinologic point of view, knowing the very low risk of node invasion to be balanced with the surgical risk. |
Keywords : colorectal cancer, sub-mucosal adenocarcinoma, intramucosal adenocarcinoma, endoscopic resection, surgery, node invasion |
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