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malignant colon polyp

In a colonoscopy, a malignant pedunculated polyp was found.
The pathological findings were:
Malignant Pedunculated polyp composed of , well differentiated, adenocarcinoma arising in villous adenoma ,
No vascular lymphatic  invasion seen,
deep margins are free of tumor distance 1.7mm                                                                                    
,   My doctors are divided in their opinions regarding going through surgery, the main indication is polyprectomy margin is 1.5 mm, which is <2 mm from deep margin. It seems that the European guidelines are to avoid surgery while the American gidlines recommend laproscopic surgical intervention.
Could you have any recommendation or medical information to help me deciede
11 Responses
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Avatar universal
I would be more apt to go with the American guidelines, however, I am not sure what you mean by "European guidelines" because in France our guideline is as the American guidelines.  Malignant polyps are NOT usually left in.  

In what countries have you consulted physicians?
Helpful - 0
Avatar universal
the polyp was cut off in the colonoscopy, the debate is about doing surgery and cuttint part of the colon to check the limph around it
Helpful - 0
527321 tn?1212630482
DH1
Yes you should have surgery to have this checked. My husband had 4 polyps removed and the 5th one was cancer, he had surgery to have the sigmoid and they removed the lymph nodes around it, the lymph nodes showed no cancer but he did have to have an ileostomy for 3 months and then they reversed it and so far he is doing fine. He gad stage 1 colorectal cancer. I hope you find the right doctor to do the right thing. My husband was at the Cleveland Clinic. Please keep us informed.
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Avatar universal
I would say go with the surgical intervention.
Helpful - 0
1806721 tn?1554333407
Hi, you cannot male decisions on pathology report alone.  

First of all, whenever you get a path report indicating cancer, ALWAYS ask your doctor to send the glass slides to a major cancer center with good pathology department for a second opinion.  It looks like your tumor is in situ and slow growing one (well differentiated and no lymphovascular invasion are a good thing, but again, these findings need to be confirmed by a second opinion).

You did not mention what the path report says about your other 4 polyps.  Are they also precancerous? Where were they located? Were they close to the area where the cancerous polyp was found?  If I had a few precancerous polyps surrounding a cancerous one in a particular part of my colon.  Personally, I'd get that part of the colon excised to prevent future growth.

Also, you need an endoscopic ultrasound to confirm clear margin and no surrounding lymph nodes enlargement.  You need abdominal CT and chest CT to confirm no metastasis and to be your baseline for future surveillance.  You need CEA blood test.  If any of the above test finds anything suspicious, I would most definitely go for surgery.

With early stage, unless you were in an emergency situation like I was (I had uncontrolled bleeding at the biopsy site), you can take your time to find yourself good doctors and make decisions when you are comfortable.  Take care & good luck!
Helpful - 0
Avatar universal
Thank you very much for your detailed resonse, the slides and margins were tested in two different labs with same pathological results, margins from healthy tissue were 1.5-1.7mm, I have decieded to do the surgery hoping for the best results without complications, and not take risks with cancer
Helpful - 0
Avatar universal
Thank you very much for your resonse,  I have decieded to do the surgery hoping for the best results without complications, and not take risks with cancer, do you have recomendations regrding preparing for and after the operation?
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Avatar universal
Thank you very much for your resonse,  I have decieded to do the surgery hoping for the best results without complications, and not take risks with cancer, do you have recomendations regrding preparing for and after the operation?
Helpful - 0
Avatar universal
Thank you again for your detailed resonse, Since  I have decieded to do the surgery, do you have recomendations regrding preparing for and after the operation?
Helpful - 0
Avatar universal
"recomendations regrding preparing for and after the operation?"  I would consult your surgeon about this.  This can't or shouldn't be addressed over the internet.

All the best.
Helpful - 0
1806721 tn?1554333407
I don't know where the tumor site was and what kind of surgery you will have.  In general, in the weeks before surgery, you want to get yourself well nourished and do a LOT of pelvic floor / Kegel exercise. Good luck!
Helpful - 0
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