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Tumor Tip of the Week-Polypectomy Staging

Tumor Tip Of The Week-Polypectomy Staging

Scenario I: 2-28-2019 Colonoscopy: screening colonoscopy found 25mm polyp removed by piecemeal mucosal resection using snare.

Pathology: Poorly diff Adenocarcinoma arising in a serrated polyp invading the submucosa. There is no mention of margins on the path report.

Scans: No evidence of adenopathy/mets and no mention of colon mass

03-15-2020 Hemicolectomy

 

Question:  How is the cT category assigned?

    • cT1
    • cTX
    • BLANK

Answer:  cT1

 

Rationale: Although the polyp was surgically removed, the Information from this surgery can be used for clinical staging because the polypectomy was not the definitive treatment but part of the diagnostic workup.

 

Scenario II: 2-28-2019 Colonoscopy: screening colonoscopy found pedunculated polyp removed with snare polypectomy.

Pathology: Invasive Poorly diff Adenocarcinoma arising in a pedunculated polyp. There is no mention of margins on the path report.

Scans: No evidence of adenopathy/mets and no mention of colon mass

No further treatment recommended.

 

Question:  How is the cT category assigned?

    • cT1
    • cTX
    • BLANK

Answer:  cT would be left BLANK

 

Rationale: The clinical staging would be BLANK, the cancer was not known or suspected prior to surgical resection.  The snare polypectomy was meant to be definitive treatment and the information from the polypectomy would be used for pathological staging only.  Pathologic stage pT1 pNX cM0 Stage 99

 

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