TTP2.12 Outcomes of laparoscopic management of colorectal polyp cancers based upon ACPGBI guidelines- is it time for a change?

Aims ACPGBI issued a position statement on the management of malignant colorectal polyps in 2013. Our study aims to evaluate the outcomes of polyp cancers managed in our cancer hub and compare the predicted rates as per ACPGBI risk assessment tool with actual outcomes. Methods Prospectively collected data of patients with polyp cancer identified over 4-year period from Jan 2020 to Dec 2023 was analysed. The rate of residual disease in each subgroup was calculated and compared with predicted risk. Surgical outcomes were measured by calculating the complication rate, length of stay and stoma rate. Results 95 patients had polyp cancer. 25 cases (24%) had risk of residual disease of < 5% and all these patients were managed by watch and wait approach with no residual disease or recurrence on follow up. 70 patients were identified as at risk of 20%. One quarter of patients within this high risk group had evidence of residual disease following surgical resection. Conclusion The ACPGBI tool accurately assesses the risk of remaining disease. The risk of surgical complications can be significant in high-risk patients. Hence, patient selection is critical. Moreover, further work should be done on other risk factors like polyp size to determine whether they can be integrated into the risk assessment tool.