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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Current strategies for malignant pedunculated colorectal polyps
Adriana Ciocalteu, Dan Ionut Gheonea, Adrian Saftoiu, Liliana Streba, Nicoleta Alice Dragoescu, Tiberiu Stefanita Tenea-Cojan
Adriana Ciocalteu, Dan Ionut Gheonea, Adrian Saftoiu, Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
Liliana Streba, Department of Oncology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
Nicoleta Alice Dragoescu, Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
Tiberiu Stefanita Tenea-Cojan, Department of General Surgery, C.F. Clinical Hospital, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Adriana Ciocalteu, MD, PhD, Assistant Professor, Department of Gastroenterology, Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, Petru Rares 2, Craiova 200349, Romania. adriana_ciocalteu@yahoo.com
Telephone: +40-743-513580
Received: September 27, 2018
Peer-review started: September 27, 2018
First decision: October 16, 2018
Revised: November 12, 2018
Accepted: November 15, 2018
Article in press: November 16, 2018
Published online: December 15, 2018
Despite significant advances in imaging techniques, the incidence of colorectal cancer has been increasing in recent years, with many cases still being diagnosed in advanced stages. Early detection and accurate staging remain the main factors that lead to a decrease in the cost and invasiveness of the curative techniques, significantly improving the outcome. However, the diagnosis of pedunculated early colorectal malignancy remains a current challenge. Data on the management of pedunculated cancer precursors, apart from data on nonpolypoid lesions, are still limited. An adequate technique for complete resection, which provides the best long-term outcome, is mandatory for curative intent. In this context, a discussion regarding the diagnosis of malignancy of pedunculated polyps, separate from non-pedunculated variants, is necessary. The purpose of this review is to provide a critical review of the most recent literature reporting the different features of malignant pedunculated colorectal polyps, including diagnosis and management strategies.
Core tip: Colorectal cancer has the highest chance of curability as long as it is detected at an early stage, before lymph node metastasis, or as a premalignant lesion. However, few relevant studies address pedunculated polyps separately from nonpolypoid type lesions, often resulting in a source of bias. The objective of this paper is to offer an up-to-date overview, particularly on the management of malignant pedunculated polyps.
