CA: A Cancer Journal for Clinicians, Vol 39, 219-225, Copyright
© 1989 by American Cancer Society
Large Bowel Adenomas
Cecilia M. Fenoglio-Preiser MD1,
Michael V. Sivak Jr. MD2, and
Jerome J. DeCosse MD, PhD3
1 Professor of Pathology at the University of New Mexico Medical School and Chief of Laboratory Service at the Veterans Administration Medical Center in Albuquerque, New Mexico.
2 Chairman of the Department of Gastroenterology at the Cleveland Clinic Foundation in Cleveland, Ohio.
3 Professor and Associate Chairman of the Department of Surgery at the Cornell University Medical College in New York, New York.
The last 20 years have witnessed dramatic technological advances in the diagnosis and treatment of colorectal polyps. These developments, in addition to an increased understanding of large bowel carcinogenesis, have shifted the risk/benefit balance toward a more aggressive approach to colorectal polyps. Mounting evidence for the adenoma-carcinoma sequence supports the position that all colorectal polyps should be removed, recovered, and evaluated. Moreover, in most cases polypectomy can be achieved endoscopically. To justify surgery today, adenomas must be too large to be removed endoscopically, located in the distal rectum, or malignant with submucosal invasion or questionable margins.
