Endoscopy and surgery. A combined strategy for diagnosis and therapy of polyposis-cancer sequence in the colon

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 descr ibe 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 su ch is the average period of time for the transformation of an adenoma into invasive carcinoma, In clinical practice, it is frequent to note synchronou s or metachronous polyps with respect to colon carcinoma. It is also possib le to note carcinoma in patients with previous polypectomies. Conclusions. On the basis of the retrospective evaluation of the clinical c ases, and reviewing international literature, the authors suggest their dia gnostic-therapeutic and endoscopic follow-up protocol for patients affected by colon neoformations (Fig. 1).