Malignant polyps are defined as cancer invading the submucosa. Polyps that are in situ without invasion of the submucosa will not show regional lymph node metastasis. The need for further surgical resection after endoscopic removal of adenomatous polyps or adenomas requires evaluation of the pathological findings and consultation with the patient. Whether invasive carcinoma is found within a tipped or untipped polyp (adenoma), if the resection is complete and the histologic features are good, no further surgery is required. Good histologic features include grade 1 or 2, no vascular lymphatic invasion, and negative cut margins. Colonic resection is also feasible for completely removed, single clot-free polyps with good histologic features and negative cut margins because of the significantly higher incidence of negative outcomes in clot-free polyps, including recurrence, mortality, and hematogenous metastases. If the specimen is fragmented, the margins cannot be evaluated, or the specimen has poor histologic features, colectomy, whole lymph node dissection, or optional laparoscopic resection is recommended. Poor histologic features include grade 3 or 4, vascular lymphatic invasion, and positive margins. Positive margins can be defined as the presence of tumor within 1-2 mm of the cross-sectional margin or tumor cells within the thermal ablation cross-section. All patients with excised polyps should undergo full colonoscopy to rule out other polyps and endoscopic follow-up. chemotherapy is not recommended for stage I patients.