Diseases of the colon and rectum
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Multicenter Study Comparative Study
Tumor pathology and long-term survival in emergency colorectal cancer.
Patients who have an emergency operation for colorectal cancer have poorer long-term survival outcomes compared with elective patients. This study was designed to define the role of tumor pathology as a basis for the differences in survival outcomes. ⋯ Advanced tumor pathology is a basis for poor long-term survival in emergency colorectal cancers.
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Multicenter Study Comparative Study
Clinicopathologic characteristics and malignant potential of colorectal flat neoplasia compared with that of polypoid neoplasia.
Because of their potential for malignancy, flat colorectal neoplasias are a current topic of debate. This study was designed to investigate the clinicopathologic features of flat neoplasia and to compare them with those of polypoid neoplasia, as well as to identify the determinants of malignant transformation of both flat and polypoid colorectal neoplasia. ⋯ The clinicopathologic indices for the propensity of malignant transformation in colorectal neoplasias were a size > or =11 mm and location in the left colon rather than flat gross morphology.
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The introduction of reimbursement for screening colonoscopy in Germany more than one year ago raised concerns that the consequent workload might lead to underuse of diagnostic colonoscopy for symptomatic patients. Available appropriateness criteria for diagnostic colonoscopy have been rarely tested in a realistic outpatient setting. This study was designed to test current appropriateness criteria for diagnostic colonoscopy to better select patients and potentially provide more capacity for screening cases. Secondary goals were yield and quality control in both the diagnostic and screening cases. ⋯ Currently used appropriateness criteria for diagnostic colonoscopy increase the yield of relevant findings but lead to a miss rate for relevant findings in the range of 10 to 15 percent. Simple selection criteria based on age and symptoms could be more suitable and should be tested in a larger group of patients.
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Multicenter Study
Detection of metachronous neoplasms in colorectal cancer patients: identification of risk factors.
Patients with colorectal cancer have a high risk of developing metachronous neoplasms. Identification of predictive factors associated with such conditions would allow individualized follow-up strategies in these patients. This study was designed to identify individual and familial factors associated with the development of metachronous colorectal neoplasms in patients with colorectal cancer. ⋯ Patients with previous or synchronous colorectal adenoma have an increased risk of developing metachronous colorectal neoplasms. Accordingly, this subgroup of patients may benefit from specific surveillance strategies.
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Multicenter Study
Impact of surgery on the development of duodenal cancer in patients with familial adenomatous polyposis.
Precancerous duodenal lesions in patients with familial adenomatous polyposis can be detected with duodenoscopy and treatment may prevent the development of cancer. We proposed to determine the frequency, natural history, cumulative risk, and risk factors of the precancerous duodenal lesions in a series of patients diagnosed in northern Italy. ⋯ Patients with familial adenomatous polyposis are at risk of significant neoplasia. The natural history of precancerous lesions might be related to surgical treatment of colorectal neoplasms.