title: [Local excision and adjuvant radiotherapy for rectal adenocarcinoma T1-2 N0].
abstract: OBJECTIVE
  To study retrospectively the relapse rate, the functional results and the survival rate in patients with rectal carcinoma treated with local excision and adjuvant radiotherapy.
  
  
  METHODS
  Between 1980 and 1995, 43 patients were treated. All cancers were infiltrating tumours except 4 high grade dysplasias with positive margins. The pT classification was: pT1 (n=34), pT2 (n=4), pT3 (n=1). In 4 cases the depth of penetration of the tumor into the bowel wall was not evaluable. The endo-anal excision was performed by surgery (n=20) or by endoscopy (n=23). Only the tumor bed was irradiated in 35 cases (contact x-ray therapy: 30, interstitial iridium implant: 5) and in 8 cases the whole rectum was irradiated with external beam radiotherapy (+/- endocavitary irradiation).
  
  
  RESULTS
  Median follow-up was 72 months. Four malignant relapses were observed (local: 1, perirectal lymphatic: 2, distant metastasis: 1). The overall 5- and 10-year survival rates were 80 and 68%, respectively. A total of 41 patients preserved a normal sphincter (95%). The anal function was evaluated as excellent or good in all the cases. No severe radiation toxicity was observed.
  
  
  CONCLUSIONS
  Small rectal carcinomas T1 N0 can be effectively treated in most cases by local excision and postoperative radiation therapy. A close multidisciplinary collaboration is necessary to achieve an optimal result.
authors.affiliation: Service de Radiothérapie-Oncologie, Centre Hospitalier Lyon-Sud, Pierre-Bénite. gerard@radiotherapie.univ-lyon1.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Gérard
authors.forename: O
authors.initials: O
authors.lastname: Chapet
authors.forename: P
authors.initials: P
authors.lastname: Romestaing
authors.forename: V
authors.initials: V
authors.lastname: Favrel
authors.forename: N
authors.initials: N
authors.lastname: Barbet
authors.forename: F
authors.initials: F
authors.lastname: Mornex
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate