Early Rectal Cancer: Local Excision or Radical Surgery?

Chang, Alexandre Jin Bok Audi; Nahas, Caio Sérgio Rizkallah; Araújo, Sérgio Eduardo Alonso; Nahas, Sérgio Carlos; Marques, Carlos Frederico Sparapan; Kiss, Desidério Roberto; Cecconello, Ivan

doi:10.1016/j.jsurg.2007.11.002

Cited by 33 publications

(20 citation statements)

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“…But for those with an infiltrated muscular layer, because the probability of lymph node metastasis is as high as 40%, it would be more prudent to consider adopting TAE to treat T2 rectal cancers. Our statistical analysis showed that as the T stage increases the incidence of postoperative recurrence tends to be higher, being 6.3% for T1 and 14.8% for T2, which is in accordance with other reports [8,21,22]. Therefore, local excision is only a palliative therapy.…”

Section: Discussionsupporting

confidence: 91%

Analysis of 116 cases of rectal cancer treated by transanal local excision

Sun

Tang

et al. 2014

World J Surg Onc

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BackgroundThe purpose of this research was to evaluate the therapeutic effects and prognostic factors of transanal local excision (TAE) for rectal cancer.MethodsWe retrospectively analyzed 116 cases that underwent TAE for rectal cancer from 1995 to 2008. A Cox regression analysis was used to analyze prognostic factors.ResultsThe survival times for the patients were from 14 to 160.5 months (median time, 58.5 months). The 5-year and 10-year overall survival rates were 72% and 53%, respectively. In all 16 cases experienced local recurrence (13.8%). Pathological type, recurrence or metastasis, and depth of infiltration (T stage) were the prognostic factors according to the univariate analysis, and the latter two were independent factors affecting patient prognosis. For patients with T1 stage who underwent adjuvant radiotherapy, there was no local recurrence; for those in T2 stage, the local recurrence rate was 14.6%. In addition, there was no difference between the patients who received radiotherapy and those who did not (T1: P = 0.260, T2: P = 0.262 for survival rate and T1: P = 0.480, T2: P = 0.560 for recurrence).ConclusionsThe result of TAE for rectal cancer is satisfactory for T1 stage tumors, but it is not suitable for T2 stage tumors.

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Section: Discussionsupporting

confidence: 91%

Analysis of 116 cases of rectal cancer treated by transanal local excision

Sun

Tang

et al. 2014

World J Surg Onc

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“…To our knowledge, this is the first report showing that risk of LNM in T2 rectal cancer is associated with depth of invasion in muscularis propria. Our results showed that the risk of LNM was significantly lower when tumor was confined within the inner layer (15.3%) compared with tumor infiltrated into 24 Considering the tremendous difference in risk of LNM between the two groups, it would be necessary to incorporate the depth of infiltration (circular or longitudinal muscularis propria infiltration) into pathological report for T2 rectal cancer resected by local excision. When final pathological report shows that longitudinal muscularis propria is invaded, salvage radical resection would be necessary.…”

Section: Discussionmentioning

confidence: 87%

Depth of Tumor Invasion Independently Predicts Lymph Node Metastasis in T2 Rectal Cancer

Ding

Cao

et al. 2011

Journal of Gastrointestinal Surgery

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“…This may be particularly relevant to discussions with patients highly averse to a stoma, as well as those that represent a high perioperative risk. Currently, LE after CRT is being mainly offered or thought to be acceptable as a palliative treatment of advanced cancers [26,27] or in patients not wishing to undergo major surgery which may necessitate stoma formation. The studies included in this analysis is composed of patients staged preoperatively T1 to T4 and any T stage with N1.…”

Section: Discussionmentioning

confidence: 99%