PMID- 26424814
OWN - NLM
STAT- MEDLINE
DCOM- 20160802
LR  - 20160318
IS  - 1472-4146 (Electronic)
IS  - 0021-9746 (Linking)
VI  - 69
IP  - 4
DP  - 2016 Apr
TI  - Adverse histological features in malignant colorectal polyps: a contemporary 
      series of 239 cases.
PG  - 292-9
LID - 10.1136/jclinpath-2015-203203 [doi]
AB  - AIMS: Screening colonoscopy has led to more colorectal carcinomas presenting at 
      an early stage potentially curable by endoscopic resection. In this study, we 
      examined the clinical and histological features of a contemporary series of 
      malignant colorectal polyps (MCPs) with subsequent surgical resection. METHODS: 
      We conducted a retrospective study on a consecutive series of MCPs from 239 
      patients, predominantly males (57.7%) with a median age of 66 years, and assessed 
      histological parameters associated with residual disease on the surgical 
      specimens. RESULTS: Median MCP size was 18.6 mm, with 23.1% polyps measuring 
      </=10 mm. From the 140 surgical resection specimens, residual disease was 
      identified in 20 cases, including 12 cases with metastatic lymph nodes and/or 9 
      cases with residual carcinoma in the large bowel wall. Histological parameters 
      associated with nodal metastases were greater width and greater depth of the 
      invasive component (p=0.001 and 0.006, respectively), poor differentiation 
      (p=0.003) and a cribriform pattern (p=0.01). The risk of nodal metastases was 
      23.3% if two or three of these features were identified, while it was 0% and 4.5% 
      if none or one was present, respectively. A positive margin was not associated 
      with nodal metastasis and might be adequately treated by local endoscopic 
      resection. CONCLUSIONS: Surgical resection should be recommended if >/=2 of these 
      adverse histological features are present and may be warranted if one feature is 
      present. A positive margin may require additional local resection but not 
      necessarily surgery if no other adverse factors are present.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/
FAU - Brown, Ian S
AU  - Brown IS
AD  - Envoi Specialist Pathologists, Brisbane, Queensland, Australia Department of 
      Anatomical Pathology, Pathology Queensland, Royal Brisbane and Women's Hospital, 
      Brisbane, Queensland, Australia.
FAU - Bettington, Mark L
AU  - Bettington ML
AD  - Envoi Specialist Pathologists, Brisbane, Queensland, Australia The Conjoint 
      Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, 
      Queensland, Australia School of Medicine, University of Queensland, Brisbane, 
      Queensland, Australia.
FAU - Bettington, Andrew
AU  - Bettington A
AD  - Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia.
FAU - Miller, Gregory
AU  - Miller G
AD  - Envoi Specialist Pathologists, Brisbane, Queensland, Australia School of 
      Medicine, University of Queensland, Brisbane, Queensland, Australia.
FAU - Rosty, Christophe
AU  - Rosty C
AD  - Envoi Specialist Pathologists, Brisbane, Queensland, Australia School of 
      Medicine, University of Queensland, Brisbane, Queensland, Australia Department of 
      Pathology, The University of Melbourne, Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20150930
PL  - England
TA  - J Clin Pathol
JT  - Journal of clinical pathology
JID - 0376601
SB  - IM
MH  - Adenocarcinoma/*pathology
MH  - Adult
MH  - Aged
MH  - Colonic Polyps/*pathology
MH  - Colonoscopy
MH  - Colorectal Neoplasms/*pathology
MH  - Female
MH  - Humans
MH  - Lymphatic Metastasis/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm, Residual/pathology
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - CANCER
OT  - COLON
OT  - GASTROINTESTINAL DISEASE
OT  - MALIGNANT TUMOURS
EDAT- 2015/10/02 06:00
MHDA- 2016/08/03 06:00
CRDT- 2015/10/02 06:00
PHST- 2015/06/16 00:00 [received]
PHST- 2015/09/10 00:00 [accepted]
PHST- 2015/10/02 06:00 [entrez]
PHST- 2015/10/02 06:00 [pubmed]
PHST- 2016/08/03 06:00 [medline]
AID - jclinpath-2015-203203 [pii]
AID - 10.1136/jclinpath-2015-203203 [doi]
PST - ppublish
SO  - J Clin Pathol. 2016 Apr;69(4):292-9. doi: 10.1136/jclinpath-2015-203203. Epub 
      2015 Sep 30.