Loading…
In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps
Aim Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival. Methods Data from the Queensland Oncology Repository was analysed to derive a po...
Saved in:
| Published in: | Colorectal disease 2023-02, Vol.25 (2), p.261-271 |
|---|---|
| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3 |
| container_end_page | 271 |
| container_issue | 2 |
| container_start_page | 261 |
| container_title | Colorectal disease |
| container_volume | 25 |
| creator | Zammit, Andrew P. Hooper, John D. Brown, Ian Clark, David A. Riddell, Andrew D. |
| description | Aim
Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival.
Methods
Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log‐rank testing, Kaplan–Meier and Cox‐regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching.
Results
A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups ( |
| doi_str_mv | 10.1111/codi.16369 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2724240086</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2778865006</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3</originalsourceid><addsrcrecordid>eNp90c1O3DAQB3ALtSpfvfAAVaReqqoBj-04yRFtS1kJiQucI8eZgFESp55kV_sCfe56CXDgUF_skX_-e6Rh7Az4OcR1YX3jzkFLXR6wI1BapiCh-PB8FmlRAj9kx0RPnIPOofjEDqUWQshSHbG_6yGxvh9NcOSHZOumx2T03W5EO_l-9yNedj7EwnRJQIoHF5mjxBB568yEzfLI9WPwm1jRHDZuE3nrQzKayeEwUdI48zB4etW96dzDYIZp-YxO2cfWdISfX_YTdn_16251nd7c_l6vLm9SK0tZpga04LbMa4mYi7qEFhsomsygahsjhM5AqRxF3dQGTamy3EAGVmKrlLQW5Qn7tuTGZv_MSFPVO7LYdWZAP1MlcqGE4rzQkX59R5_8HIbYXVR5UeiM8736vigbPFHAthqD603YVcCr_XSq_XSq5-lE_OUlcq57bN7o6zgigAVsXYe7_0RVq9uf6yX0Hz3Vnc8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2778865006</pqid></control><display><type>article</type><title>In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Zammit, Andrew P. ; Hooper, John D. ; Brown, Ian ; Clark, David A. ; Riddell, Andrew D.</creator><creatorcontrib>Zammit, Andrew P. ; Hooper, John D. ; Brown, Ian ; Clark, David A. ; Riddell, Andrew D.</creatorcontrib><description>Aim
Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival.
Methods
Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log‐rank testing, Kaplan–Meier and Cox‐regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching.
Results
A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups (<60 years of age or ≥60 years of age), American Society of Anesthesiology score, comorbidity count or Association of ColoProctology of Great Britain and Ireland risk category. However, of note Log‐rank testing demonstrated a significant difference in OS (p < 0.001) and CSS (p = 0.0061) between management strategies. Multivariable Cox‐regression models in matched and un‐matched patient cohorts demonstrated significantly lower hazards of death for OS with resection (p < 0.001). However, CSS was no longer significantly different between management groups in multivariable Cox‐regression analysis (p = 0.073).
Conclusion
Patients who underwent colorectal resection had significantly improved OS and CSS compared with polypectomy alone. Improved OS was furthermore seen on multivariable analysis, and in matched cohorts. Future research should investigate why this unexpected finding may be the case and whether updates to guidelines should be considered.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.16369</identifier><identifier>PMID: 36222394</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Age ; Colonic Polyps - surgery ; Colonoscopy ; colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - surgery ; colorectal surgery ; Comorbidity ; Forecasting ; Humans ; malignant polyps ; Middle Aged ; polypectomy ; Polyps ; Proportional Hazards Models ; Regression analysis ; Retrospective Studies ; Statistical analysis ; Survival</subject><ispartof>Colorectal disease, 2023-02, Vol.25 (2), p.261-271</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.</rights><rights>2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3</citedby><cites>FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3</cites><orcidid>0000-0001-6329-2547 ; 0000-0002-8648-0919 ; 0000-0003-4083-220X ; 0000-0003-1054-8486 ; 0000-0002-2065-3012</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36222394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zammit, Andrew P.</creatorcontrib><creatorcontrib>Hooper, John D.</creatorcontrib><creatorcontrib>Brown, Ian</creatorcontrib><creatorcontrib>Clark, David A.</creatorcontrib><creatorcontrib>Riddell, Andrew D.</creatorcontrib><title>In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival.
Methods
Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log‐rank testing, Kaplan–Meier and Cox‐regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching.
Results
A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups (<60 years of age or ≥60 years of age), American Society of Anesthesiology score, comorbidity count or Association of ColoProctology of Great Britain and Ireland risk category. However, of note Log‐rank testing demonstrated a significant difference in OS (p < 0.001) and CSS (p = 0.0061) between management strategies. Multivariable Cox‐regression models in matched and un‐matched patient cohorts demonstrated significantly lower hazards of death for OS with resection (p < 0.001). However, CSS was no longer significantly different between management groups in multivariable Cox‐regression analysis (p = 0.073).
Conclusion
Patients who underwent colorectal resection had significantly improved OS and CSS compared with polypectomy alone. Improved OS was furthermore seen on multivariable analysis, and in matched cohorts. Future research should investigate why this unexpected finding may be the case and whether updates to guidelines should be considered.</description><subject>Age</subject><subject>Colonic Polyps - surgery</subject><subject>Colonoscopy</subject><subject>colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - surgery</subject><subject>colorectal surgery</subject><subject>Comorbidity</subject><subject>Forecasting</subject><subject>Humans</subject><subject>malignant polyps</subject><subject>Middle Aged</subject><subject>polypectomy</subject><subject>Polyps</subject><subject>Proportional Hazards Models</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Survival</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp90c1O3DAQB3ALtSpfvfAAVaReqqoBj-04yRFtS1kJiQucI8eZgFESp55kV_sCfe56CXDgUF_skX_-e6Rh7Az4OcR1YX3jzkFLXR6wI1BapiCh-PB8FmlRAj9kx0RPnIPOofjEDqUWQshSHbG_6yGxvh9NcOSHZOumx2T03W5EO_l-9yNedj7EwnRJQIoHF5mjxBB568yEzfLI9WPwm1jRHDZuE3nrQzKayeEwUdI48zB4etW96dzDYIZp-YxO2cfWdISfX_YTdn_16251nd7c_l6vLm9SK0tZpga04LbMa4mYi7qEFhsomsygahsjhM5AqRxF3dQGTamy3EAGVmKrlLQW5Qn7tuTGZv_MSFPVO7LYdWZAP1MlcqGE4rzQkX59R5_8HIbYXVR5UeiM8736vigbPFHAthqD603YVcCr_XSq_XSq5-lE_OUlcq57bN7o6zgigAVsXYe7_0RVq9uf6yX0Hz3Vnc8</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Zammit, Andrew P.</creator><creator>Hooper, John D.</creator><creator>Brown, Ian</creator><creator>Clark, David A.</creator><creator>Riddell, Andrew D.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6329-2547</orcidid><orcidid>https://orcid.org/0000-0002-8648-0919</orcidid><orcidid>https://orcid.org/0000-0003-4083-220X</orcidid><orcidid>https://orcid.org/0000-0003-1054-8486</orcidid><orcidid>https://orcid.org/0000-0002-2065-3012</orcidid></search><sort><creationdate>202302</creationdate><title>In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps</title><author>Zammit, Andrew P. ; Hooper, John D. ; Brown, Ian ; Clark, David A. ; Riddell, Andrew D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Colonic Polyps - surgery</topic><topic>Colonoscopy</topic><topic>colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - surgery</topic><topic>colorectal surgery</topic><topic>Comorbidity</topic><topic>Forecasting</topic><topic>Humans</topic><topic>malignant polyps</topic><topic>Middle Aged</topic><topic>polypectomy</topic><topic>Polyps</topic><topic>Proportional Hazards Models</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zammit, Andrew P.</creatorcontrib><creatorcontrib>Hooper, John D.</creatorcontrib><creatorcontrib>Brown, Ian</creatorcontrib><creatorcontrib>Clark, David A.</creatorcontrib><creatorcontrib>Riddell, Andrew D.</creatorcontrib><collection>Wiley Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zammit, Andrew P.</au><au>Hooper, John D.</au><au>Brown, Ian</au><au>Clark, David A.</au><au>Riddell, Andrew D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2023-02</date><risdate>2023</risdate><volume>25</volume><issue>2</issue><spage>261</spage><epage>271</epage><pages>261-271</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim
Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer‐specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival.
Methods
Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log‐rank testing, Kaplan–Meier and Cox‐regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching.
Results
A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups (<60 years of age or ≥60 years of age), American Society of Anesthesiology score, comorbidity count or Association of ColoProctology of Great Britain and Ireland risk category. However, of note Log‐rank testing demonstrated a significant difference in OS (p < 0.001) and CSS (p = 0.0061) between management strategies. Multivariable Cox‐regression models in matched and un‐matched patient cohorts demonstrated significantly lower hazards of death for OS with resection (p < 0.001). However, CSS was no longer significantly different between management groups in multivariable Cox‐regression analysis (p = 0.073).
Conclusion
Patients who underwent colorectal resection had significantly improved OS and CSS compared with polypectomy alone. Improved OS was furthermore seen on multivariable analysis, and in matched cohorts. Future research should investigate why this unexpected finding may be the case and whether updates to guidelines should be considered.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36222394</pmid><doi>10.1111/codi.16369</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6329-2547</orcidid><orcidid>https://orcid.org/0000-0002-8648-0919</orcidid><orcidid>https://orcid.org/0000-0003-4083-220X</orcidid><orcidid>https://orcid.org/0000-0003-1054-8486</orcidid><orcidid>https://orcid.org/0000-0002-2065-3012</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1462-8910 |
| ispartof | Colorectal disease, 2023-02, Vol.25 (2), p.261-271 |
| issn | 1462-8910 1463-1318 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2724240086 |
| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Age Colonic Polyps - surgery Colonoscopy colorectal cancer Colorectal carcinoma Colorectal Neoplasms - surgery colorectal surgery Comorbidity Forecasting Humans malignant polyps Middle Aged polypectomy Polyps Proportional Hazards Models Regression analysis Retrospective Studies Statistical analysis Survival |
| title | In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T22%3A53%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=In%20comparison%20with%20polypectomy,%20colorectal%20resection%20is%20associated%20with%20improved%20survival%20for%20patients%20diagnosed%20with%20malignant%20polyps&rft.jtitle=Colorectal%20disease&rft.au=Zammit,%20Andrew%20P.&rft.date=2023-02&rft.volume=25&rft.issue=2&rft.spage=261&rft.epage=271&rft.pages=261-271&rft.issn=1462-8910&rft.eissn=1463-1318&rft_id=info:doi/10.1111/codi.16369&rft_dat=%3Cproquest_cross%3E2778865006%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3939-a1620c97b3ee72b91fed18d5ae4fda22651447e2bdbaea9457a151c3ef443cce3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2778865006&rft_id=info:pmid/36222394&rfr_iscdi=true |