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Panminerva Medica 2001 March;43(1):21-6

lingua: Inglese

Endoscopy and surgery. A combined strategy for diagnosis and therapy of polyposis-cancer sequence in the colon

Scorza R., De Monti M., Ghilardi G., Sgroi G., Kunkl E.

From the Chair of General Surgery University of Milan, Milan, Italy


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Background. The aim of the ­paper is to eval­uate ret­ro­spec­tively the ­series of ­patients ­affected by ­colon ­polyps and ­colon ­cancer to pur­pose a ­planned ­follow-up for ­patients who under­went ­colon poly­pec­tomy.
Methods. Out of 198 ­patients ­affected by ­colon car­ci­noma, the ­authors ­describe 95 ­cases of pre­vious, syn­chro­nous or met­a­chro­nous ­polyps, ­with a ­global prev­a­lence of 47.9%, and respec­tively of 13.6%, 16.6%, and 17.6%.
Results. The evol­u­tive ­sequence ­between ­colon ­polyp and car­ci­noma is ­shown ­through ­both clin­ical expe­ri­ence and experi­mental ­tests. The epi­dem­i­ologic ­curve of ­adenoma ­rate pre­cedes by ­five ­years the ­curve of car­ci­noma, and ­such is the ­average ­period of ­time for the trans­for­ma­tion of an ­adenoma ­into inva­sive car­ci­noma. In clin­ical prac­tice, it is fre­quent to ­note syn­chro­nous or met­a­chro­nous ­polyps ­with ­respect to ­colon car­ci­noma. It is ­also pos­sible to ­note car­ci­noma in ­patients ­with pre­vious poly­pec­to­mies.
Conclusions. On the ­basis of the ret­ro­spec­tive eval­u­a­tion of the clin­ical ­cases, and ­reviewing inter­na­tional lit­er­a­ture, the ­authors sug­gest ­their diag­nostic-ther­a­peutic and endo­scopic ­follow-up pro­tocol for ­patients ­affected by ­colon neo­for­ma­tions (Fig. 1)

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