Histological criteria for local excision

Abstract

There are good clinical, technical and pathological reasons for making a distinction between malignant polyps treated by endoscopic polypectomy', large sessile adenomas of the rectum containing a focus of invasive carcinoma treated b local excision, and local excision for small ulcerating cancers .

Optimizing the Outcome for Patients With Rectal Cancer

“…Among many histologic factors examined the depth of invasion, tumor grade and lymphovascular invasion consistently correlate with the likelihood of nodal spread. 31,32,35,36 The presence of mucinous histology 31 and/or tumor ulceration 32 have also been reported to be significant predictive factors. It should be noted however that any biopsy specimen from a rectal cancer, because of tumor heterogeneity, may not accurately predict the features of the whole tumor specimen.…”

Transanal Endoscopic Microsurgery - State of the Art

“…Depths of invasion into the rectal wall, grade or degree of differentiation, vascular, lymphatic and neural invasion are independent predictors of the risk of nodal metastasis. Since initial studies by Morson (Morson, 1985) and Hermanek (Hermanek & Marzoli, 1994) large series of resected rectal cancers have shown that well-differentiated tumors confined to the submucosa (T1) without vascular, lymphatic or neural invasion carry a 4% risk of nodal metastasis.…”

Local Excision of Rectal Cancer: The Operation of Y. Mason

“…The selection includes clinical and histopathological criteria, but only the defini tive histological assessment of the specimen allows to determine or not the adequacy of the excision [12,13].…”