| Large or suspicious polyps
Hereditary syndromes Dysplasia/Carcinoma in situ in biopsy spe- cimens,
Incomplete, questionable margins on polypectomy |
For COVID-19 Phase I - III Hospitals surgery would be delayed until the pandemic abates and resources return |
| Early cancer in resected polyp |
Consider deferring surgery vs. resection |
Defer Surgery |
| Asymptomatic Cancer T1-2 N0 |
Resect |
Resect vs. deferring surgery |
Defer surgery |
| Asymptomatic Cancer Colon T3-4, N0 and Tx N+ |
Resect |
Resect vs. deferring surgery |
Consider chemotherapy vs. transfer |
| Rectal T3-4, N0 and Tx N+ |
Induction chemotherapy versus chemoradiation versus radiation, consider extended chemothe- rapy, also consider delaying surgery up to 12-16 weeks following completion of radiation |
| Symptomatic cancers defined as bleed- ing requiring transfusion, obstructing or near-obstructing, impending perforation |
Resect |
Resect, consider stent vs. stoma |
Stoma vs. stent, consider transfer |