Histologic Evaluation of Malignant Polyps and Low-Stage Colorectal Carcinoma
Catherine E Hagen1, Ayesha Farooq1
1From the Department of Pathology, Medical College of Wisconsin, Milwaukee.
Context.—:
With widespread screening for colorectal cancer, the number of early-stage colorectal cancers is increasing. Local excision of pT1 tumors is associated with considerably less morbidity and mortality, but this must be weighed against risk of lymph node metastases.
Objective.—:
To understand histologic prognostic factors associated with adverse outcome in malignant polyps.
Data Sources.—:
Pertinent literature regarding histologic features of prognostic significance in malignant polyps and low-stage colorectal carcinomas is summarized and our institute's cases are used to highlight these histologic features.
Conclusions.—:
Poor prognostic factors for malignant polyps include high tumor grade, presence of lymphovascular invasion, tumor less than 1 mm from resection margin, submucosal invasion deeper than 1 mm, and high tumor budding. These features should be assessed by the pathologist and communicated to the clinical team in order to allow proper management.
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