Treatment of Rectal Cancer in a Pedunculated Rectal Polyp (pT1) After Complete Endoscopic Removal with Clear Margins

This protocol applies to invasive cancer (pT1) found within a pedunculated adenoma of the rectum that was excised endoscopically as a single, intact specimen — with clear resection margins and favorable histologic features confirmed on pathology.

The lesion is a pedunculated polyp (adenoma) of the rectum containing invasive cancer staged pT1. The polyp was completely removed endoscopically as a single specimen. Histologic assessment confirmed favorable features: grade 1 or 2, no angiolymphatic invasion, and a negative resection margin.

When these specific histologic and staging criteria are met, the protocol specifies a conservative course of action — the full structured approach is accessible below.

The complete protocol defines the recommended next step for this scenario, including what further intervention, if any, is indicated.

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References

Pedunculated polyp or sessile polyp (adenoma) with invasive cancer.

Single specimen, completely removed with favorable histologic features and clear margins (pT1 only).

In patients with pedunculated polyps (adenomas), no additional surgery is required if the polyp has been completely removed endoscopically with favorable histologic features.

Favorable histologic features include lesions of grade 1 or 2 without angiolymphatic invasion and with a negative resection margin.