Management of the Malignant Rectal Polyp-A Narrative Review.

PURPOSE

The aim of this review is to provide a contemporary update on the current management approaches and options with specific considerations in malignant rectal polyps.

METHODS

A literature review was carried out in PubMed, Embase and Cochrane databases using the keywords "malignant" and "polyp*". Only publications in English language were included.

RESULTS

Histopathological features including margins, depth of invasion, tumour grade, LVI and tumour budding determines the risk of lymph node metastasis in malignant polyps. Rectal malignant polyps should be considered differently compared to their colonic counterpart. A low threshold should be considered for utilising transrectal excision to fully excise the polyp and to assess the margins. The rates of complete pathological response associated with total neoadjuvant therapy as well as the advent of "watch and wait" adds to the complexity of managing malignant rectal polyps.

CONCLUSIONS

The management of malignant colorectal polyps lies in risk-stratifying patients who will benefit from an oncological resection.