{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:52:50Z","timestamp":1783950770160,"version":"3.55.0"},"reference-count":67,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: The aim of this review is to provide a contemporary update on the current management approaches and options with specific considerations in malignant rectal polyps. Methods: A literature review was carried out in PubMed, Embase and Cochrane databases using the keywords \u201cmalignant\u201d and \u201cpolyp*\u201d. Only publications in English language were included. Results: Histopathological features including margins, depth of invasion, tumour grade, LVI and tumour budding determines the risk of lymph node metastasis in malignant polyps. Rectal malignant polyps should be considered differently compared to their colonic counterpart. A low threshold should be considered for utilising transrectal excision to fully excise the polyp and to assess the margins. The rates of complete pathological response associated with total neoadjuvant therapy as well as the advent of \u201cwatch and wait\u201d adds to the complexity of managing malignant rectal polyps. Conclusions: The management of malignant colorectal polyps lies in risk-stratifying patients who will benefit from an oncological resection.<\/jats:p>","DOI":"10.3390\/cancers17091464","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:21:31Z","timestamp":1745817691000},"page":"1464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of the Malignant Rectal Polyp\u2014A Narrative Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2196-4645","authenticated-orcid":false,"given":"Zhen Hao","family":"Ang","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Prince of Wales Hospital, Sydney, NSW 2031, Australia"},{"name":"Randwick Campus, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2033, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shing Wai","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Prince of Wales Hospital, Sydney, NSW 2031, Australia"},{"name":"Randwick Campus, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2033, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"998","DOI":"10.2174\/18735592MTEx9NTk2y","article-title":"Colorectal Cancer Epidemiology: Recent Trends and Impact on Outcomes","volume":"22","author":"Baidoun","year":"2021","journal-title":"Curr. Drug Targets"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.5306\/wjco.v15.i9.1136","article-title":"Colorectal cancer: Recent advances in management and treatment","volume":"15","author":"Fadlallah","year":"2024","journal-title":"World J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1053\/j.gastro.2020.08.050","article-title":"Endoscopic Recognition and Management Strategies for Malignant Colorectal Polyps: Recommendations of the US Multi-Society Task Force on Colorectal Cancer","volume":"159","author":"Shaukat","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/codi.12262","article-title":"Management of the malignant colorectal polyp: ACPGBI position statement","volume":"15","author":"Williams","year":"2013","journal-title":"Color. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3103","DOI":"10.3748\/wjg.v16.i25.3103","article-title":"Malignant colorectal polyps","volume":"16","author":"Bujanda","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1055\/s-2007-1004268","article-title":"Invasive carcinoma in colorectal adenomas: Multivariate analysis of patient and adenoma characteristics","volume":"29","author":"Nusko","year":"1997","journal-title":"Endoscopy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101124","DOI":"10.1016\/j.cpsurg.2022.101124","article-title":"Management of the malignant colorectal polyp","volume":"59","author":"Symer","year":"2022","journal-title":"Curr. Probl. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1038\/ajg.2009.403","article-title":"High accuracy of narrow band imaging without magnification for the real-time characterization of polyp histology and its comparison with high-definition white light colonoscopy: A prospective study","volume":"104","author":"Rastogi","year":"2009","journal-title":"Am. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.gie.2013.04.185","article-title":"Endoscopic prediction of deep submucosal invasive carcinoma: Validation of the narrow-band imaging international colorectal endoscopic (NICE) classification","volume":"78","author":"Hayashi","year":"2013","journal-title":"Gastrointest. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1053\/j.gastro.2012.05.006","article-title":"Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging","volume":"143","author":"Hewett","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S0016-5107(96)70222-5","article-title":"Diagnosis of colorectal tumorous lesions by magnifying endoscopy","volume":"44","author":"Kudo","year":"1996","journal-title":"Gastrointest. Endosc."},{"key":"ref_12","unstructured":"(2025, April 12). Polyp Classification: NICE Endoscopy Campus. Available online: https:\/\/www.endoscopy-campus.com\/en\/classifications\/polyp-classification-nice\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0016-5107(94)70216-0","article-title":"The non-lifting sign of invasive colon cancer","volume":"40","author":"Uno","year":"1994","journal-title":"Gastrointest. Endosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1053\/j.gastro.2017.05.047","article-title":"Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort","volume":"153","author":"Burgess","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"12649","DOI":"10.3748\/wjg.v20.i35.12649","article-title":"Kudo\u2019s pit pattern classification for colorectal neoplasms: A meta-analysis","volume":"20","author":"Li","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1136\/gutjnl-2020-323666","article-title":"Oncological outcomes after piecemeal endoscopic mucosal resection of large non-pedunculated colorectal polyps with covert submucosal invasive cancer","volume":"71","author":"Gibson","year":"2022","journal-title":"Gut"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1055\/s-0033-1344238","article-title":"Predicting lymph node metastasis in pT1 colorectal cancer: A systematic review of risk factors providing rationale for therapy decisions","volume":"45","author":"Bosch","year":"2013","journal-title":"Endoscopy"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.1007\/s00464-013-2835-5","article-title":"Pathologic predictive factors for lymph node metastasis in submucosal invasive (T1) colorectal cancer: A systematic review and meta-analysis","volume":"27","author":"Mou","year":"2013","journal-title":"Surg. Endosc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/0016-5085(85)90333-6","article-title":"Prognostic factors in colorectal carcinomas arising in adenomas: Implications for lesions removed by endoscopic polypectomy","volume":"89","author":"Haggitt","year":"1985","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1007\/BF02049154","article-title":"Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines","volume":"38","author":"Kikuchi","year":"1995","journal-title":"Dis. Colon. Rectum"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"398","DOI":"10.3346\/jkms.2015.30.4.398","article-title":"Meta-analysis of predictive clinicopathologic factors for lymph node metastasis in patients with early colorectal carcinoma","volume":"30","author":"Choi","year":"2015","journal-title":"J. Korean Med. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1007\/s00535-004-1339-4","article-title":"Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: A Japanese collaborative study","volume":"39","author":"Kitajima","year":"2004","journal-title":"J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1111\/codi.12129","article-title":"Systematic review and meta-analysis of histopathological factors influencing the risk of lymph node metastasis in early colorectal cancer","volume":"15","author":"Beaton","year":"2013","journal-title":"Color. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF02050592","article-title":"The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma","volume":"34","author":"Nivatvongs","year":"1991","journal-title":"Dis. Colon. Rectum"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"16178","DOI":"10.3748\/wjg.v20.i43.16178","article-title":"Management of malignant colon polyps: Current status and controversies","volume":"20","author":"Aarons","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/DCR.0b013e3182336c38","article-title":"Rate of residual disease after complete endoscopic resection of malignant colonic polyp","volume":"55","author":"Butte","year":"2012","journal-title":"Dis. Colon. Rectum"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1002\/1097-0142(19891101)64:9<1937::AID-CNCR2820640929>3.0.CO;2-X","article-title":"Colorectal adenomas containing invasive carcinoma. Pathologic assessment of lymph node metastatic potential","volume":"64","author":"Coverlizza","year":"1989","journal-title":"Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1007\/s10350-005-0063-3","article-title":"Histologic risk factors and clinical outcome in colorectal malignant polyp: A pooled-data analysis","volume":"48","author":"Hassan","year":"2005","journal-title":"Dis. Colon. Rectum"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.2147\/CMAR.S181740","article-title":"Pathological risk factors for lymph node metastasis in patients with submucosal invasive colorectal carcinoma","volume":"11","author":"Zhang","year":"2019","journal-title":"Cancer Manag. Res."},{"key":"ref_30","unstructured":"National Comprehensive Cancer Network (2025, February 02). Colon Cancer (Version 1.2025) 2024. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/colon.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e298","DOI":"10.1016\/j.cgh.2020.11.032","article-title":"Risk and Time Pattern of Recurrences After Local Endoscopic Resection of T1 Colorectal Cancer: A Meta-analysis","volume":"20","author":"Dang","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Peluso, G., Incollingo, P., Calogero, A., Tammaro, V., Rupealta, N., Chiacchio, G., Sotelo, M.L.S., Minieri, G., Pisani, A., and Riccio, E. (2017). Current Tissue Molecular Markers in Colorectal Cancer: A Literature Review. Biomed. Res. Int., 2017.","DOI":"10.1155\/2017\/2605628"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1038\/nm.3967","article-title":"The consensus molecular subtypes of colorectal cancer","volume":"21","author":"Guinney","year":"2015","journal-title":"Nat. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1038\/s41379-020-0598-9","article-title":"Associations of non-pedunculated T1 colorectal adenocarcinoma outcome with consensus molecular subtypes, immunoscore, and microsatellite status: A multicenter case-cohort study","volume":"33","author":"Haasnoot","year":"2020","journal-title":"Mod. Pathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2702","DOI":"10.7150\/jca.25646","article-title":"Analysis of the expression of cancer-associated fibroblast- and EMT-related proteins in submucosal invasive colorectal cancer","volume":"9","author":"Sugai","year":"2018","journal-title":"J. Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3349\/ymj.2015.56.1.175","article-title":"Clinical implications of microsatellite instability in T1 colorectal cancer","volume":"56","author":"Kang","year":"2015","journal-title":"Yonsei Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/codi.16328","article-title":"Management of high and low risk malignant polyps: A population-wide analysis","volume":"25","author":"Zammit","year":"2023","journal-title":"Color. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1111\/codi.16716","article-title":"Management of malignant T1 colorectal cancer polyps: Results from a 10-year prospective observational study","volume":"25","author":"Johnstone","year":"2023","journal-title":"Color. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"114","DOI":"10.3393\/ac.2023.00178.0025","article-title":"Estimation of risk posed by malignant polyps amongst colorectal surgeons in Australia and New Zealand","volume":"40","author":"Zammit","year":"2024","journal-title":"Ann. Coloproctol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"627","DOI":"10.5152\/tjg.2022.211103","article-title":"Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement","volume":"33","author":"Aytac","year":"2022","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/SLA.0000000000003251","article-title":"Definition of the Rectum: An International, Expert-based Delphi Consensus","volume":"270","author":"Tiret","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1055\/s-0036-1582438","article-title":"Management of Rectal Polyps","volume":"29","author":"Cowan","year":"2016","journal-title":"Clin. Colon. Rectal Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5375","DOI":"10.3748\/wjg.v16.i42.5375","article-title":"Patterns of lymph node metastasis are different in colon and rectal carcinomas","volume":"16","author":"Wang","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/codi.14526","article-title":"The MRI assessment of SPECC (significant polyps and early colorectal cancer) lesions","volume":"21","author":"Balyasnikova","year":"2019","journal-title":"Color. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101987","DOI":"10.1016\/j.suronc.2023.101987","article-title":"Magnetic resonance imaging accuracy in staging early and locally advanced rectal cancer","volume":"50","author":"Arndt","year":"2023","journal-title":"Surg. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1093\/bjs\/znac059","article-title":"Accuracy of MRI in early rectal cancer: National cohort study","volume":"109","author":"Nilsson","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101739","DOI":"10.1016\/j.suronc.2022.101739","article-title":"The importance of MRI for rectal cancer evaluation","volume":"43","author":"Fernandes","year":"2022","journal-title":"Surg. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1007\/s10350-004-0903-6","article-title":"Endorectal ultrasound in the management of patients with malignant rectal polyps","volume":"48","author":"Rothenberger","year":"2005","journal-title":"Dis. Colon. Rectum"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1245\/s10434-008-0231-5","article-title":"How good is endoscopic ultrasound in differentiating various T stages of rectal cancer? Meta-analysis and systematic review","volume":"16","author":"Puli","year":"2009","journal-title":"Ann. Surg. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"102151","DOI":"10.1016\/j.suronc.2024.102151","article-title":"Diagnostic accuracy and treatment benefit of PET\/CT in staging of colorectal cancer compared to conventional imaging","volume":"57","author":"Engel","year":"2024","journal-title":"Surg. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Jiang, W., Dou, X., Zhang, N., Yu, J., Zhao, L., and Yue, J. (2024). Multidisciplinary Team Meeting Significantly Enhances Disease-Free Survival in Stage II-III Rectal Cancer. Clin. Colorectal Cancer, ahead of print.","DOI":"10.1016\/j.clcc.2024.12.006"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.canep.2018.01.009","article-title":"The impact of rectal cancer tumor height on recurrence rates and metastatic location: A competing risk analysis of a national database","volume":"53","author":"Augestad","year":"2018","journal-title":"Cancer Epidemiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s10350-004-6147-7","article-title":"Risk of lymph node metastasis in T1 carcinoma of the colon and rectum","volume":"45","author":"Nascimbeni","year":"2002","journal-title":"Dis. Colon. Rectum"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2949","DOI":"10.1111\/ans.17917","article-title":"A population-based study of the management of rectal malignant polyps and the use of trans-anal surgery","volume":"92","author":"Zammit","year":"2022","journal-title":"ANZ J. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/codi.14493","article-title":"Endoscopic excision of significant polyp and early colorectal cancer lesions","volume":"21","author":"East","year":"2019","journal-title":"Colorectal Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1245\/ASO.2003.01.441","article-title":"Transanal endoscopic microsurgery: A viable operative alternative in selected patients with rectal lesions","volume":"10","author":"Neary","year":"2003","journal-title":"Ann. Surg. Oncol."},{"key":"ref_57","first-page":"CD002198","article-title":"Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy","volume":"6","author":"Motamedi","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s10151-017-1595-y","article-title":"Long-term results of transanal endoscopic microsurgery after endoscopic polypectomy of malignant rectal adenoma","volume":"21","author":"Junginger","year":"2017","journal-title":"Tech. Coloproctol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00384-023-04584-6","article-title":"Endoscopic and trans-anal local excision vs. radical resection in the treatment of early rectal cancer: A systematic review and network meta-analysis","volume":"39","author":"Kwik","year":"2023","journal-title":"Int. J. Color. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Van Butsele, J., Bislenghi, G., D\u2019Hoore, A., and Wolthuis, A.M. (2021). Readmission after rectal resection in the ERAS-era: Is a loop ileostomy the Achilles heel?. BMC Surg., 21.","DOI":"10.1186\/s12893-021-01242-y"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1007\/s10350-004-0930-3","article-title":"Surgical salvage of recurrent rectal cancer after transanal excision","volume":"48","author":"Weiser","year":"2005","journal-title":"Dis. Colon. Rectum"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"E196","DOI":"10.1503\/cjs.005822","article-title":"Total neoadjuvant therapy for rectal cancer: A guide for surgeons","volume":"66","author":"Johnson","year":"2023","journal-title":"Can. J. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1200\/JCO.22.00032","article-title":"Organ Preservation in Patients with Rectal Adenocarcinoma Treated with Total Neoadjuvant Therapy","volume":"40","author":"Patil","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"4218","DOI":"10.3748\/wjg.v26.i29.4218","article-title":"Watch and wait approach in rectal cancer: Current controversies and future directions","volume":"26","author":"Ferreiro","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_65","first-page":"17","article-title":"Colorectal malignant polyps: A modern approach","volume":"35","author":"Saraiva","year":"2022","journal-title":"Ann. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1111\/codi.16056","article-title":"Can we Save the rectum by watchful waiting or TransAnal surgery following (chemo)Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR-TREC)? Protocol for the international, multicentre, rolling phase II\/III partially randomized patient preference trial evaluating long-course concurrent chemoradiotherapy versus short-course radiotherapy organ preservation approaches","volume":"24","author":"Bach","year":"2022","journal-title":"Color. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"6402","DOI":"10.1007\/s00464-023-09979-8","article-title":"One-year review of real-time artificial intelligence (AI)-aided endoscopy performance","volume":"37","author":"Chin","year":"2023","journal-title":"Surg. Endosc."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/9\/1464\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:22:35Z","timestamp":1760030555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/9\/1464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,27]]},"references-count":67,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["cancers17091464"],"URL":"https:\/\/doi.org\/10.3390\/cancers17091464","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,27]]}}}