Preoperative staging and treatment options in T1 rectal adenocarcinoma

Baatrup, Gunnar; Endreseth, Birger Henning; Isaksen, Vidar; Kjellmo, Åse; Nesbakken, Arild

doi:10.1080/02841860802657243

Cited by 31 publications

(13 citation statements)

References 103 publications

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“…In our series, absence of remaining neoplastic tissue in the biopsy results in the decision simply to observe the patient. This management policy has been advocated recently by a Norwegian group [32]. In the presence of a residual T1 tumor, performing this kind of biopsy allows precise submucosal staging and consequent adaptation of therapeutic strategy according to the high-or low-risk tumor.…”

Section: Excisional Biopsymentioning

confidence: 99%

Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements

et al. 2011

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The findings showed TEM to be a safe and effective procedure for local excision of rectal lesions with a low recurrence rate and minimal consequences in terms of anorectal function. In addition, TEM proved to be feasible and effective for pelvic abscess drainage and rectal stenosis treatment. New technologies such as the Harmonic scalpel and ESD increase the precision already offered by this approach.

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Section: Excisional Biopsymentioning

confidence: 99%

Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements

et al. 2011

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“…In any event, precise preoperative staging is critical in the selection of appropriate patients to optimize results. 72 With the advancement of magnetic resonance imaging (MRI), the accuracy in staging rectal cancer has increased significantly. Studies report MRI accuracy of 65%-100% in the staging of rectal cancer.…”

Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

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“…The recurrence rate is lower in the case of excision of large adenomas; most studies report around 5% (23). Even in some patients with T1 cancer full-thickness TEM excision with wide margins may be curative (24). However, TEM has some disadvantages compared with laser treatment.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Snare Resection Followed by Laser Ablation in the Treatment of Large, Sessile Rectal Adenomas

et al. 2011

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Background and Aims: large sessile rectal adenomas can be difficult to eradicate, and different treatment modalities are available. the aim of this study was to evaluate outcome after endoscopic snare resection followed by nd:yag laser ablation.Material and Methods: over a 10-year period 92 of 99 (93%) patients were registered prospectively and attended follow-up examinations with endoscopy and biopsies.Results: fifty-four (59%) men and 38 (41%) women were included; 67 patients (73%) had high grade (severe) intraepithelial dysplasia or intramucosal neoplasia. the adenomas ranged from 2-9 cm (median 4 cm) in diameter, and were located 2-15 cm (median 5 cm) from the anal verge. a median of two (range 1-6) piecemeal snare resection sessions and a median of one (range 1-7) laser treatments were performed for each patient.complete eradication was achieved in 86 patients (93%). over a median follow-up period of 26 months, 20/86 (23%) suffered local recurrence, eight of whom were given a second laser treatment without developing further recurrence. in five of eight frail patients considered unsuitable for more radical treatment, repeated laser treatment was effective in keeping the adenoma small and symptoms at a minimum. as a whole the treatment was successful in 74/92 (80%) and partially successful in 5/92 (5%) of the patients.Conclusions: snare resection followed by laser ablation is safe and still has a place in the treatment of old, frail patients with large rectal adenomas. however, there is a risk of missing an infiltrating carcinoma, and other treatment options are preferable in fit patients.

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Preoperative staging and treatment options in T1 rectal adenocarcinoma

Cited by 31 publications

References 103 publications

Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements

Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements

Transanal endoscopic microsurgery: a review

Endoscopic Snare Resection Followed by Laser Ablation in the Treatment of Large, Sessile Rectal Adenomas

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