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Early Colorectal Cancer

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Multidisciplinary Treatment of Colorectal Cancer
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Abstract

This chapter explains the terminology and classification of colorectal neoplastic precursor lesions, with focus on serrated lesions: hyperplastic polyp, sessile serrated adenoma/polyp (or lesion), mixed polyp and traditional serrated adenoma. We refer to practical issues, such as the measurement of polyp size and the grading of intraepithelial neoplasia/dysplasia (low grade vs. high grade). The definition of invasion is driven by the World Health Organization and defined as invasion into the submucosal layer. Risk assessment of pT1 colorectal cancers is the prerequisite of clinical decision making ranging from follow-up only to additional endoscopic and surgical procedures. The evaluation is based upon the following parameters: depth of invasion (for sessile lesions reported according to Kikuchi levels sm1–sm3; for polypoid/pedunculated lesions reported according to Haggitt levels I–IV), tumour grade, vascular invasion, margin involvement, budding (tumour cell dissociation at the invasion front) and (possibly) perineural invasion.

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Langner, C., Vieth, M. (2015). Early Colorectal Cancer. In: Baatrup, G. (eds) Multidisciplinary Treatment of Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-06142-9_21

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