NCCN Guidelines for Patients
Colon Cancer, Version 1.2017
Part 4 is a treatment guide for colon
cancer that hasn’t spread to distant sites.
The cancer is confined within the colon,
has grown to nearby structures, or has
spread to nearby lymph nodes. Treatment
options are partly based on cancer stage.
lists the treatment options for tumors rated
as T1. These tumors haven’t grown beyond the
second layer of the colon wall. They are sometimes
called “polyps with cancer” because the cancer
hasn’t grown far.
Some people with T1 tumors will need treatment.
Treatment is based on the shape of the polyp and
whether cancer will likely return after a polypectomy.
Shapes of polyps are shown in
cancer is more likely to return if these high-risk
features are present:
is a tumor that was
removed in pieces.
Positive surgical margin
is cancer within the
normal-looking tissue around the tumor.
Unknown surgical margin
is unclear results of
the normal-looking tissue around the tumor.
Cancer grade 3 or 4
means cancer cells don’t
look much like normal cells.
is cancer spread
into the tumor’s lymph and blood vessels.
is a group of 5 or fewer cancer
cells separate from the main tumor.
A polypectomy likely removed all the cancer if you
had a pedunculated polyp without high-risk features.
No more treatment is advised. You can start follow-
For a sessile polyp without high-risk features, there
are two options if the polyp was fully removed. You
may start follow-up testing. Surgery is also an option.
Guide 4. Treatment for T1 tumors
What are the options?
without high-risk features • Start follow-up testing
Sessile polyp without
• Start follow-up testing
• Colectomy +
Any polyp with high-risk
• Colectomy +
Shapes of polyps
Treatment for stage I, T1 tumors is partly
based on the shape of the polyp. A
pedunculated polyp has a stalk and round
top. A sessile polyp doesn’t have a stalk.
Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved.www.nucleusinc.com