Outcome of malignant colorectal polyps - better than expected: a contemporary series of 172 cases

• Published in: Pathology 2014, Vol.46, p.S60-S60
• Main Authors: Bettington, Andrew, Lin, Linda, Bettington, Mark, Brown, Ian
• Format: Article
• Language: English
• ISSN: 0031-3025; 1465-3931
• DOI: 10.1097/01.PAT.0000443535.02238.08

To examine colectomy specimens performed for colorectal polyp found to harbour invasive adenocarcinoma. Colectomy specimens performed for malignant colorectal polyp (MCP) received by Envoi Pathology between March 2007 and September 2013 were reviewed for residual lesion and lymph node status. Where available the initial MCP was reviewed for: invasive tumour size, Haggitt level, vascular invasion, tumour differentiation, adequacy of resection and presence of tumour budding or focal dedifferentiation. 172 resections following MCP were identified with M:F = 2:1, median age 66 years, left colon location 70%, lymph node metastases 4.1%. Residual adenoma in 7.5% and adenocarcinoma in 2.15% was present when complete polypectomy had been performed. One hundred and twenty MCP (70%) were available for review. Findings were: width > 4 mm or depth > 2 mm, 57%; poor differentiation, 24%; tumour budding, 39%, lymphatic invasion, 30%, venous invasion, 8.3%; margin < 1 mm, 57%. Despite ‘high risk’ features, residual disease is infrequent in the subsequent resection. Conservative treatment may be appropriate in select patients.