EURECCA colorectal: Multidisciplinary management: European consensus conference colon & rectum

Transanal Endoscopic Microsurgery

“…In low-risk pT1 tumors, lymphatic spread occurs in only 3% of patients compared to 12% in pT1 high-risk tumors, which translates into higher local recurrences in high-risk pT1 tumors treated by local excision. Our 5.8% recurrence rate for low risk T1 tumors compares very favorably to the literature [6,22,23]. Tumors must be located at the extraperitoneal part of the rectum using the full-thickness technique.…”

“…Salm et al [21] in another study about the experience with TEM in Germany, report 5,7% of radical rectal resection in patients with advanced cancer in the post-TEM histological specimen. However, when the TEM was established starting the use for T1 cancers with favorable histology including the depth of submucosal invasion and low risk of lymph node metastases [22][23][24]. The incalculable threat after local resection is the risk of lymphatic metastasis.…”

Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference

“…Whilst several consensus conferences focusing on the diagnosis, staging and treatment of locally advanced rectal cancer have been recently published [1][2][3], there are no specific consensus conferences on ERC.…”

Completion proctectomy following transanal endoscopic microsurgery for early rectal cancer

“…In terms of oncological results, local excision of early rectal cancer (pT1) by TEM has equivalent outcomes to radical resection [10,11,13,14] . Due to abovementioned advantageous attributes, the use of TEM for early rectal cancer is now considered a viable option in selected patients, and may be offered to patents with lesions pre-operatively staged as T1N0, with tumor diameter < 4 cm involving less than 30% of the rectal wall circumference, and no histological risk factors [16][17][18][19][20] . Preoperative staging with endoscopic rectal ultrasound (ERUS) and magnetic resonance imaging (MRI) of rectal lesions aid in decision making of selection for local treatment or radical resection.…”