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In this work, we review the literature on TSA in the oesophagus, the stomach, the duodenum, the pancreatic main duct and the gallbladder. The review indicated that 53.4% (n=39) out of the 73 TSA of the upper digestive tract now in record showed a simultaneously growing invasive carcinoma. As a corollary, TSAs of the upper digestive tract are aggressive adenomas that should be radically excised, either endoscopically or surgically, to rule out the possibility of a synchronously growing invasive adenocarcinoma or to prevent cancer progression. The present findings substantiate a TSA pathway of carcinogenesis in the upper digestive tract.<\/jats:p>","DOI":"10.1136\/jclinpath-2015-203258","type":"journal-article","created":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T23:28:09Z","timestamp":1444865289000},"page":"1-5","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Traditional serrated adenomas of the upper digestive tract"],"prefix":"10.1136","volume":"69","author":[{"given":"CA","family":"Rubio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,14]]},"reference":[{"key":"2025092504324316000_69.1.1.1","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S1055-3207(18)30361-2","article-title":"The adenoma\u2013carcinoma sequence in colorectal neoplasia","volume":"5","author":"O'Brien","year":"1996","journal-title":"Surg Oncol Clin N Am"},{"key":"2025092504324316000_69.1.1.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199006000-00003"},{"key":"2025092504324316000_69.1.1.3","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9896(200103)193:3<283::AID-PATH799>3.0.CO;2-9"},{"key":"2025092504324316000_69.1.1.4","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8608884"},{"key":"2025092504324316000_69.1.1.5","first-page":"380","article-title":"Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept","volume":"124","author":"Snover","year":"2005","journal-title":"Am J Surg Pathol"},{"key":"2025092504324316000_69.1.1.6","doi-asserted-by":"publisher","DOI":"10.1111\/his.12564"},{"key":"2025092504324316000_69.1.1.7","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.315"},{"key":"2025092504324316000_69.1.1.8","first-page":"4929","article-title":"Two phenotypes of traditional serrated adenomas. 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