ORIGINAL ARTICLES   

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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

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)