NCCN Guidelines for Patients
Rectal Cancer, Version 1.2017
Part 4 is a treatment guide for rectal
cancer that hasn’t spread to distant sites.
The cancer is confined within the rectum,
has grown to nearby structures, or has
spread to nearby lymph nodes. Treatment
options are partly based on cancer stage.
Stage I consists of either T1 or T2 tumors. T1 tumors
haven’t grown beyond the second layer of the rectal
wall. They are sometimes called “polyps with cancer”
because the cancer hasn’t grown far. T2 tumors
haven’t grown beyond the third layer. Stage I cancers
have not spread to lymph nodes or distant sites.
Not all people with T1 tumors will need treatment.
Treatment is based on the polyp shape and if there’s
still cancer in your body. Shapes of polyps are shown
. Cancer is more likely present 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.
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
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