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Pitfalls during histological assessment in locally resected pT1 colorectal cancer

Pitfalls during histological assessment in locally resected pT1 colorectal cancer
Pitfalls during histological assessment in locally resected pT1 colorectal cancer
Colorectal cancer (CRC) is a common malignancy worldwide, and the stage of the tumour is closely related to clinical outcome. Bowel cancer screening programmes have resulted in the identification of colorectal cancer at earlier stages. Approximately 10% of patients with the earliest stage of CRC (i.e. pT1) will possess regional lymph node metastases (LNM). Therefore, if these patients have initially been treated by local resection (e.g. polypectomy), this subgroup will require surgical resection. Identification of pathological risk factors for LNM within locally resected pT1 CRC is a very important process during the histological assessment of these lesions. This paper describes the most commonly encountered and clinically significant difficulties in the histological assessment of these cases. These pitfalls are illustrated using four examples of locally resected pT1 CRC that were received by our department during routine diagnostic practice.
colorectal cancer, histology, risk assessment
1365-2559
357-367
Norton, Emma
76746af3-fcfc-40cb-aa84-c8da09c830db
Bateman, Adrian C.
7f25dc01-ee35-42b1-8dba-19086664c637
Norton, Emma
76746af3-fcfc-40cb-aa84-c8da09c830db
Bateman, Adrian C.
7f25dc01-ee35-42b1-8dba-19086664c637

Norton, Emma and Bateman, Adrian C. (2025) Pitfalls during histological assessment in locally resected pT1 colorectal cancer. Histopathology, 87 (3), 357-367. (doi:10.1111/his.15425).

Record type: Review

Abstract

Colorectal cancer (CRC) is a common malignancy worldwide, and the stage of the tumour is closely related to clinical outcome. Bowel cancer screening programmes have resulted in the identification of colorectal cancer at earlier stages. Approximately 10% of patients with the earliest stage of CRC (i.e. pT1) will possess regional lymph node metastases (LNM). Therefore, if these patients have initially been treated by local resection (e.g. polypectomy), this subgroup will require surgical resection. Identification of pathological risk factors for LNM within locally resected pT1 CRC is a very important process during the histological assessment of these lesions. This paper describes the most commonly encountered and clinically significant difficulties in the histological assessment of these cases. These pitfalls are illustrated using four examples of locally resected pT1 CRC that were received by our department during routine diagnostic practice.

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Histopathology - 2025 - Pitfalls during histological assessment in locally resected pT1 colorectal cancer - Version of Record
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Accepted/In Press date: 27 January 2025
e-pub ahead of print date: 12 February 2025
Published date: September 2025
Keywords: colorectal cancer, histology, risk assessment

Identifiers

Local EPrints ID: 508737
URI: http://eprints.soton.ac.uk/id/eprint/508737
ISSN: 1365-2559
PURE UUID: 9fcbb6ec-b276-4556-8c4f-c457d252614c
ORCID for Emma Norton: ORCID iD orcid.org/0000-0003-1877-2474

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Date deposited: 02 Feb 2026 17:57
Last modified: 02 Feb 2026 17:57

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Contributors

Author: Emma Norton ORCID iD
Author: Adrian C. Bateman

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