title: Malignancy in large colorectal lesions.
abstract: BACKGROUND
  The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion objectives: To evaluate the malignancy of colorectal lesions ≥20 mm.
  
  
  METHODS
  Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed.
  
  
  RESULTS
  The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm). Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3%) lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5%) and IV (53.9%) pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma), with no difference in morphology and site. Only one lesion (1.3%) invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001). The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%.
  
  
  CONCLUSIONS
  Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.
authors.affiliation: Departamento de Gastroenterologia e Endoscopia Digestiva, Hospital Santa Casa, Bagé, RS, Brasil.
authors.forename: Carlos Eduardo Oliveira dos
authors.initials: CE
authors.lastname: Santos
authors.affiliation: Departamento de Gastroenterologia e Endoscopia Digestiva, Hospital Santa Casa, Bagé, RS, Brasil.
authors.forename: Daniele
authors.initials: D
authors.lastname: Malaman
authors.affiliation: Departamento de Gastroenterologia e Endoscopia Digestiva, Hospital Santa Casa, Bagé, RS, Brasil.
authors.forename: Tiago dos Santos
authors.initials: Tdos S
authors.lastname: Carvalho
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, Brasil.
authors.forename: César Vivian
authors.initials: CV
authors.lastname: Lopes
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, Brasil.
authors.forename: Júlio Carlos
authors.initials: JC
authors.lastname: Pereira-Lima
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male