Highlights
- •Little data on omitting resection for early-stage malignant colorectal polyps.
- •Patient selection critical when pursuing organ-sparing strategies.
- •Survival with non-operative management equivalent in select settings.
Abstract
Background
Non-operative management of early-stage polypectomy-identified colorectal cancer (CRC)
may be a safe alternative, but limited data exist.
Methods
We compared outcomes between adults with post-polypectomy CRC who did and did not
ultimately undergo resection from 2003 to 2018. Overall (OS) and recurrence-free (RFS)
survival were calculated via log rank analysis using the Mantel-Cox method and plotted
on Kaplan-Meier curves with significance evaluated at P < 0.05.
Results
N = 78 patients were included, most commonly with rectal/rectosigmoid CRC (45%). Almost
half (47%) had resections, and the remaining 41 patients (53%) underwent organ-sparing
techniques. Chemoradiation was administered to 5 of these 41 patients (12%), all with
rectal cancer. At median follow-up of 52 months, 5-year OS and RFS were 78% and 100%
with no significant differences when compared to resection (all P > 0.1).
Discussion
Using evidence-based patient selection and adjuvant therapy, organ-sparing management
provides equal survival when compared to resection for post-polypectomy CRC.
Keywords
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Article info
Publication history
Published online: February 28, 2022
Accepted:
February 25,
2022
Received in revised form:
February 3,
2022
Received:
November 14,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
