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Management of Pt1 tumours removed by endoscopy during colorectal cancer screening: Outcome and treatment quality indicators

التفاصيل البيبلوغرافية
العنوان: Management of Pt1 tumours removed by endoscopy during colorectal cancer screening: Outcome and treatment quality indicators
المؤلفون: Nereo Segnan, Marco Silvani, Mario Fracchia, Carlo Senore, Giorgio Maria Saracco, Davide Giuseppe Ribaldone, Alessia Ciancio, Ilaria Giovo, Arrigo Arrigoni, Paola Cassoni
المصدر: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 44(12)
سنة النشر: 2018
مصطلحات موضوعية: Adenoma, Male, medicine.medical_specialty, Cancer epidemiology, Colorectal cancer screening, Diagnosis, Surgery, Oncology, Population, Colonoscopy, Context (language use), 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Mass Screening, education, Lymph node, Mass screening, Early Detection of Cancer, Aged, Neoplasm Staging, Quality Indicators, Health Care, Retrospective Studies, education.field_of_study, medicine.diagnostic_test, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Endoscopy, medicine.anatomical_structure, Treatment Outcome, Italy, 030220 oncology & carcinogenesis, Lymphatic Metastasis, 030211 gastroenterology & hepatology, Female, Radiology, business, Colorectal Neoplasms
الوصف: Introduction Limited information is available about outcomes of patients with malignant adenomas endoscopically resected at screening. The aim of the study was to evaluate diagnostic and therapeutic quality indicators and to correlate them with clinical and surgical outcomes. Materials and methods We reviewed endoscopic and histology characteristics of all pT1 tumours endoscopically removed at the time of colonoscopy assessment in subjects with a positive screening test result in the context of a population-based program. Results 392 pT1 tumours were completely removed by endoscopy (en-bloc = 86.7%, piecemeal = 13.3%) and the histology report was considered complete in 83.2% of cases. Treatment was limited to endoscopic excision for 120 patients (30.7%, Group 1), 272 (69.3%, Group 2) underwent radicalisation surgery. In patients who had at least 1 lymph node examined, the rate of nodal involvement was 5.4% (13/239); no metastatic node was found in the 21 (27.6%) out of 76 patients with low-risk adenomas, who underwent surgery. Conclusion Risk of nodal involvement in colorectal pT1 tumours is well predicted by known histologic features also in a screening setting, although it was lower than among patients from clinical series. Surgical overtreatment is still significantly present and there is ample room for improvement regarding diagnostic and therapeutic flow-chart.
تدمد: 1532-2157
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c559d8feb9e93d71dcb65d8a1c68bae6
https://pubmed.ncbi.nlm.nih.gov/30343994
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....c559d8feb9e93d71dcb65d8a1c68bae6
قاعدة البيانات: OpenAIRE
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