title: Factors associated with complete endoscopic resection of an invasive adenocarcinoma in a colorectal adenoma.
abstract: OBJECTIVE
  endoscopic polypectomy may allow curative resection of invasive adenocarcinoma on colorectal adenoma. Our goal was to determine the factors associated with complete endoscopic resection of invasive adenocarcinoma.
  
  
  METHODS
  retrospective observational study. We included 151 patients with invasive adenocarcinoma on adenomas endoscopically resected between 1999 and 2009. We determined those variables independently related to incomplete resection by a logistic regression. Relation was expressed as Odds Ratio (OR) and its 95% confidence interval (95% CI).
  
  
  RESULTS
  patients were predominantly male (66.2%) and their mean age was 68.03 ± 10.65 years. Colonoscopy was completein 84% of the patients and 60.3% had synchronous adenomas. Invasive adenocarcinoma was mainly located in distal colon (90.7%) and morphology was pedunculated in 75.5%. The endoscopic averagesize was 22.61 ± 10.86 mm. Submucosal injection was required in 32.5%. Finally, the resection was in one piece in 73.5% and incomplete in 8.6% of the adenocarcinomas. Factors independently associated with incomplete endoscopic resection were size (mm) (OR 1.08, 95% CI 1.03-1.14, p = 0.002), sessile or flat morphology (OR 8.78, 95% CI 2.24-34.38, p = 0.002) and incomplete colonoscopy (OR 4.73, 95% CI 1.15-19.34, p = 0.03).
  
  
  CONCLUSIONS
  endoscopic polypectomy allows complete resection of 91.4% of invasive adenocarcinomas on colorrectal adenoma in our series. Factors associated with incomplete resection were the size of the lesion, sessile or flat morphology and incomplete colonoscopy.
authors.affiliation: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Quintas
authors.forename: J
authors.initials: J
authors.lastname: Cubiella
authors.forename: I
authors.initials: I
authors.lastname: Couto
authors.forename: L
authors.initials: L
authors.lastname: Bujanda
authors.forename: C
authors.initials: C
authors.lastname: Cobian
authors.forename: I
authors.initials: I
authors.lastname: Castro
authors.forename: J
authors.initials: J
authors.lastname: Fernández-Seara
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D016001:Confidence Intervals; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies