Analysis of Surgical Outcome of Gastric Adenomatous Polyp

ABSTRACT

PURPOSE: Adenomatous polyps in the stomach are rather uncommon, however are related to a malignant transformation. So, in such cases it is important to predict cancer risk and to select an appropriate surgical method. The aim of this study is to examine clinicopathologic factor for predicting malignancy and determine appropriate surgical management of gastric adenomatous polyps. METHODS: A total 41 patients who underwent surgery from 1996 to 1999 for gastric adenomatous polyps at the Department of Surgery, Seoul National University Hospital were included this study. All patients had undergone preoperative endoscopic biopsy and histology was confirmed. Authors analyzed the clinicopathologic factors associated with malignancy and the outcome of surgical treatment. RESULTS: Of the 41 patients, 17 patients had an adenomatous polyp alone, 24 patients had an adenomatous polyp associated with malignancy. The location, number, size and morphology of the polyp were not associated with malignancy. Only cellular atypism in the preoperative biopsy was significantly associated with malignancy. 31 patients underwent subtotal gastrectomy whereas 10 patients wedge resection. All lymph nodes resected in patients with adenocarcinoma were negative. Recurrence of polyp or adenocarcinoma had not occurred in any patients after follow-up of mean 22 months. CONCLUSION: Cellular atypism detected in preoperative histology was associated with malignancy in gastric adenomatous polyp. Lymph node metastasis was negative in patients with malignancy. Our findings support the wedge resection withsafe margin as being appropriate in surgical management of gastric adenomatous polyps.