Key Concepts

• Detailed polyp assessment is the first crucial step in determining the best therapeutic strategy.
• Endoscopic resection of low-risk T1 colorectal cancer is an effective treatment in select patients.
• En-bloc resection is crucial for adequate histopathologic assessment for curative intent.
• Transanal endoscopic surgery is another technique that permits full-thickness en-bloc resection for select malignant polyps or early cancers in the rectum.
• All polyps with predictors of deep submucosal invasion should be referred for surgery given the high risk for lymph node metastasis.