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Colorectal malignant polyps: a modern approach.

Sofia Saraiva1, Isadora Rosa1, Ricardo Fonseca2

  • 1Gastroenterology Department (Sofia Saraiva, Isadora Rosa, António Dias Pereira).

Annals of Gastroenterology
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Summary
This summary is machine-generated.

Malignant polyps (MPs) in the colon require careful assessment of risk factors for accurate cancer staging and treatment. Differentiating high-risk features is crucial for guiding management decisions and improving patient outcomes.

Keywords:
Colorectal malignant polypcolorectal cancerendoscopic resectionsurveillance

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Area of Science:

  • Gastroenterology
  • Oncology
  • Surgical Pathology

Background:

  • Colorectal malignant polyps (MPs) are characterized by submucosal invasion and carry a risk of lymph node metastasis.
  • Advances in endoscopic imaging enable optical diagnosis of T1 colorectal cancer, influencing therapeutic choices.
  • Management of MPs diagnosed post-endoscopic removal presents challenges in risk stratification.

Purpose of the Study:

  • To review prognostic features of colorectal malignant polyps.
  • To discuss modern management strategies for colorectal malignant polyps.
  • To highlight the importance of differentiating low- and high-risk histologic features.

Main Methods:

  • Review of current literature on colorectal malignant polyps.
  • Analysis of morphological, endoscopic, and histologic features for risk assessment.
  • Evaluation of therapeutic modalities based on risk stratification.

Main Results:

  • High-risk histologic features necessitate surgical intervention in most cases.
  • Location, patient comorbidities, and preferences influence management decisions.
  • Watch-and-wait strategies after chemoradiotherapy show promise for low rectal MPs with high-risk features.

Conclusions:

  • Accurate assessment of malignant polyp features is vital for optimal treatment and surveillance.
  • Personalized management plans considering risk factors and patient status are essential.
  • Modern approaches, including conservative strategies for select cases, are evolving.