T1 colorectal cancer management in the era of minimally invasive endoscopic resection

Table 2 Pre-resection optical evaluation of colorectal polyps

Optical evaluation	Corresponding histopathology	Suspicion of malignancy	Recommended management
NICE I, JNET I	Serrated Polyp	Low	Endoscopic polypectomy, EMR, CSR
NICE II, JNET II	Adenomatous Polyp	Low	If suspected superficial invasion: en-bloc resection by EMR1, ESD, EFTR, TES2 If suspected deep invasion: surgery or multidisciplinary review
JNET IIB	Superficial submucosal invasion	Yes, superficial
NICE III, JNET III	Deep submucosal invasion	Yes, deep
Paris 0-IIa+Is granular lesions in distal colorectum	Covert submucosal invasion	Yes
Paris 0-Is/0-IIa+Is nongranular lesions in distal colorectum	Covert submucosal invasion	Yes

¹Applicable for lesions < 20 mm.

²Applicable to rectal lesions.

CSR: Cold snare resection; EFTR: Endoscopic full-thickness resection; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; JNET: Japan NBI Expert Team; NICE: NBI International Colorectal Endoscopic; TES: Transanal endoscopic surgery.