Pathologic Issues in the Treatment of Endoscopically Removed Malignant Colorectal Polyps

Author:
Harry S. Cooper From the Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.

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Volume/Issue:
Volume 5: Issue 9
Online Publication Date:
Oct 2007
DOI:
https://doi.org/10.6004/jnccn.2007.0083
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Endoscopically removed malignant colorectal polyps are early stage cancers for which treatment depends on histopathologic findings. For accurate pathologic evaluation, the polyps should be received in 1 piece because margins cannot be accurately assessed in fragmented polyps. Polyps with grade I or II cancer, no lymphovascular invasion, and a negative resection margin can be successfully treated with endoscopic polypectomy, whereas those with grade III cancer, lymphovascular invasion, or a positive or close margin require definitive surgical resection after endoscopic polypectomy. Potentially new significant parameters for patient management are depth of invasion and tumor budding. The pathology report must be clear and concise, indicating all relevant important parameters. The pathologist must differentiate invasive adenocarcinoma from intramucosal adenocarcinoma and pseudo-invasion.

Correspondence: Harry S. Cooper, MD, Department of Pathology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111. E-mail: hs_cooper@fccc.edu
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2007 by the National Comprehensive Cancer Network
Page Numbers:
6
Article Category:
Research Article
Received:
17 Apr 2007
Accepted:
13 Jun 2007
Print Publication Date:
01 Oct 2007
Online Publication Date:
Oct 2007
Keywords:
Malignant colorectal polyps; treatment; histopathology

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