J Korean Soc Coloproctol.  2007 Apr;23(2):87-92. 10.3393/jksc.2007.23.2.87.

Local Control of Local Excision for T1/T2 Rectal Cancer

• Park KJ
• Choi HJ
• Roh YH
• Shin JS
• Lee HS

• KMID: 1510044
• DOI: http://doi.org/10.3393/jksc.2007.23.2.87

Abstract

PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection.
METHODS
This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months.
RESULTS
Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.

Keyword

Rectal cancer; Local excision; Local recurrence

MeSH Terms

Follow-Up Studies
Humans
Liver
Neoplasm Metastasis
Rectal Neoplasms*
Recurrence
Retrospective Studies