Local excision of rectal tumors.
Local excision of rectal cancer is done with the goal of cure or palliation with minimal morbidity. Careful patient selection is paramount to avoid local recurrence. Endorectal sonography has brought accuracy to the preoperative staging of rectal cancer. Patients with ultrasound stage T1 carcinoma of the distal rectum and well-differentiated or moderately well-differentiated histology can be offered local excision, with expected low morbidity and a low risk of recurrence. Pathologic examination of the entire specimen determines favorable or unfavorable histologic features, and is the basis for final decisions made on therapy. The role of adjuvant therapy after local excision is still being defined. Preoperative chemoradiation followed by local excision appears promising for patients with more advanced or very distal tumors who have a complete pathologic response to the neoadjuvant therapy.
Marcet
Jorge E
JE
Section of Colon and Rectal Surgery, Department of Surgery, University of South Florida, Tampa, USA.
Karl
Richard C
RC
D017024:Chemotherapy, Adjuvant; D004564:Electrocoagulation; D019160:Endosonography; D006801:Humans; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012307:Risk Factors