Outcomes for early rectal cancer managed with transanal endoscopic microsurgery: a 5-year follow-up study.
BACKGROUND
This study aimed to evaluate the long-term risk of local and distant recurrence as well as the survival of patients with early rectal cancer treated using transanal endoscopic microsurgery (TEM).


METHODS
The study reviewed 69 patients with Tis/T1/T2 rectal cancer treated using full-thickness excision between 1991 and 1999. The pathology T-stages included 25 Tis, 23 T1, and 21 T2. The median follow-up period was 6.5 years (range 5-10.2 years).


RESULTS
The overall local recurrence rate was 8.7%. The 5-year local recurrence rate was 8% for Tis, 8.6% for T1, and 9.5% for T2. All six patients with recurrence were managed surgically. The 5-year disease-specific survival rate was 100% for Tis, 100% for T1, and 70% for T2. The overall cancer-related mortality rate was 7.2%.


CONCLUSIONS
After local excision of early rectal cancer, a substantial local recurrence rate is observed. Patients with recurrent Tis/T1 cancers who undergo a salvage operation may achieve good long-term outcome. Local treatment without adjuvant therapy for T2 rectal cancers appears inadequate.
Stipa
F
F
Department of Surgery, S. Giovanni Hospital Rome, via Salaria 332, 00199 Rome, Italy. francescostipa@yahoo.it
Burza
A
A
Lucandri
G
G
Ferri
M
M
Pigazzi
A
A
Ziparo
V
V
Casula
G
G
Stipa
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D011182:Postoperative Care; D011300:Preoperative Care; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome