PMID- 25708762
OWN - NLM
STAT- MEDLINE
DCOM- 20151127
LR  - 20191210
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 81
IP  - 3
DP  - 2015 Mar
TI  - Endoscopic and surgical treatment of malignant colorectal polyps: a 
      population-based comparative study.
PG  - 733-740.e2
LID - S0016-5107(14)02505-X [pii]
LID - 10.1016/j.gie.2014.11.049 [doi]
AB  - BACKGROUND: Long-term population-based data comparing endoscopic therapy (ET) and 
      surgery for management of malignant colorectal polyps (MCPs) are limited. 
      OBJECTIVE: To compare colorectal cancer (CRC)-specific survival with ET and 
      surgery. DESIGN AND SETTING: Population-based study. PATIENTS: Patients with 
      stage 0 and stage 1 MCPs were identified from the Surveillance Epidemiology and 
      End Results (SEER) database (1998-2009). Demographic characteristics, tumor size, 
      location, treatment modality, and survival were compared. Propensity-score 
      matching and Cox proportional hazards regression models were used to evaluate the 
      association between treatment and CRC-specific survival. INTERVENTIONS: ET and 
      surgery. MAIN OUTCOME MEASUREMENTS: Mid-term (2.5 years) and long-term (5 years) 
      CRC-free survival rates and independent predictors of CRC-specific mortality. 
      RESULTS: Of 10,403 patients with MCPs, 2688 (26%) underwent ET and 7715 (74%) 
      underwent surgery. Patients undergoing ET were more likely to be older white men 
      with stage 0 disease. Surgical patients had more right-sided lesions, larger 
      MCPs, and stage 1 disease. There was no difference in the 2.5-year and 5-year 
      CRC-free survival rates between the 2 groups in stage 0 disease. Surgical 
      resection led to higher 2.5-year (97.8% vs 93.2%; P < .001) and 5-year (96.6% vs 
      89.8%; P < .001) CRC-free survival in stage 1 disease. These results were 
      confirmed by propensity-score matching. ET was a significant predictor for 
      CRC-specific mortality in stage 1 disease (hazard ratio 2.40; 95% confidence 
      interval, 1.75-3.29; P < .001). LIMITATIONS: Comorbidity index not available, 
      selection bias. CONCLUSIONS: ET and surgery had comparable mid- and long-term 
      CRC-free survival rates in stage 0 disease. Surgical resection is the recommended 
      treatment modality for MCPs with submucosal invasion.
CI  - Copyright (c) 2015 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Mounzer, Rawad
AU  - Mounzer R
AD  - Division of Gastroenterology and Hepatology, University of Colorado Anschutz 
      Medical Center, Aurora, Colorado, USA.
FAU - Das, Ananya
AU  - Das A
AD  - Arizona Center for Digestive Health, Gilbert, Arizona, USA.
FAU - Yen, Roy D
AU  - Yen RD
AD  - Division of Gastroenterology and Hepatology, University of Colorado Anschutz 
      Medical Center, Aurora, Colorado, USA.
FAU - Rastogi, Amit
AU  - Rastogi A
AD  - University of Kansas School of Medicine and Veterans Affairs Medical Center, 
      Kansas City, Missouri, USA.
FAU - Bansal, Ajay
AU  - Bansal A
AD  - University of Kansas School of Medicine and Veterans Affairs Medical Center, 
      Kansas City, Missouri, USA.
FAU - Hosford, Lindsay
AU  - Hosford L
AD  - Division of Gastroenterology and Hepatology, University of Colorado Anschutz 
      Medical Center, Aurora, Colorado, USA.
FAU - Wani, Sachin
AU  - Wani S
AD  - Division of Gastroenterology and Hepatology, University of Colorado Anschutz 
      Medical Center, Aurora, Colorado, USA; Division of Gastroenterology and 
      Hepatology, Veterans Affairs Medical Center, Denver, Colorado, USA.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Video-Audio Media
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Adenocarcinoma/mortality/*therapy
MH  - Adenoma/mortality/*therapy
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Colectomy
MH  - *Colonoscopy
MH  - Colorectal Neoplasms/mortality/*therapy
MH  - Female
MH  - Humans
MH  - Intestinal Polyps/mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Propensity Score
MH  - Rectum/*surgery
MH  - SEER Program
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2015/02/25 06:00
MHDA- 2015/12/15 06:00
CRDT- 2015/02/25 06:00
PHST- 2014/09/24 00:00 [received]
PHST- 2014/11/21 00:00 [accepted]
PHST- 2015/02/25 06:00 [entrez]
PHST- 2015/02/25 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0016-5107(14)02505-X [pii]
AID - 10.1016/j.gie.2014.11.049 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2015 Mar;81(3):733-740.e2. doi: 10.1016/j.gie.2014.11.049.