Rectal cancer
ICD-10 C20 · ICD-11 2B92

Treatment of Rectal Cancer in a Sessile Polyp (pT1) Completely Removed with Clear Margins

This protocol addresses rectal cancer arising within a sessile adenoma of the rectum where the cancer is confined to the submucosa (pT1) and the lesion was removed as a single specimen with clear surgical margins and favorable histologic characteristics.

The pathologic findings define a well-circumscribed situation: a sessile rectal polyp with focal invasive cancer (pT1), excised as a single specimen and completely removed. Favorable histology — including low-grade differentiation, negative margins, and no lymphovascular invasion — characterises this sub-population. Both endoscopic polypectomy and rectal surgery are recognised management options in this setting.

Management is guided by the pathologic stage. Adjuvant treatment may be considered based on the findings, with a perioperative window of up to approximately six months. Full regimen details, sequencing, and individualised recommendations are available in the complete protocol.

References

  • Sessile polyp with invasive cancer
  • Single specimen, completely removed with favorable histologic features and clear margins (pT1 only)
  • Endoscopically removed malignant sessile polyps with grade I or II histology, negative margins, and no lymphovascular invasion can be successfully treated with endoscopic polypectomy alone.
  • Rectal surgery is also an option for these patients.
  • Adjuvant Treatment (REC-3)
  • Adjuvant Treatment (REC-4)
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