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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2015; 21(17): 5149-5157
Published online May 7, 2015. doi: 10.3748/wjg.v21.i17.5149
Non-polypoid colorectal neoplasms: Classification, therapy and follow-up
Antonio Facciorusso, Matteo Antonino, Marianna Di Maso, Michele Barone, Nicola Muscatiello
Antonio Facciorusso, Matteo Antonino, Marianna Di Maso, Michele Barone, Nicola Muscatiello, Department of Medical Sciences, Section of Gastroenterology, University of Foggia, 71100 Foggia, Italy
Author contributions: Antonino M and Di Maso M performed the bibliographic research; Facciorusso A wrote the paper; Barone M and Muscatiello N revised the manuscript; all the authors contributed to the article.
Conflict-of-interest: None of the authors have received fees for serving as a speaker or are consultant/advisory board member for any organizations. None of the authors have received research funding from any organizations. None of the authors are employees of any organizations. None of the authors own stocks and/or share in any organizations. None of the authors own patents.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Facciorusso, MD, Department of Medical Sciences, Section of Gastroenterology, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 1, 71100 Foggia, Italy. antonio.facciorusso@virgilio.it
Telephone: +39-88-1732154 Fax: +39-88-1733848
Received: December 10, 2014
Peer-review started: December 11, 2014
First decision: January 22, 2015
Revised: February 3, 2015
Accepted: March 19, 2015
Article in press: March 19, 2015
Published online: May 7, 2015
Processing time: 154 Days and 8.8 Hours
Core Tip

Core tip: Non polypoid tumors (NPTs) are distinguished in slightly elevated (0-IIa, less than 2.5 mm), flat (0-IIb) or slightly depressed (0-IIc). NPTs are usually flat or slightly elevated while depressed lesions show an increased risk of submucosal invasion (SMI). Chromoendoscopy or, if possible, narrow-band imaging technique should be considered for the estimation of SMI risk of NPTs, and the characterization of pit and vascular pattern may be useful to predict the risk of SMI. Endoscopic mucosal resection remains the first-line therapy for NPTs, whereas endoscopic submucosal dissection or surgery should be considered for larger neoplasms presenting SMI.