Is surgery-only the adequate treatment approach for T2N0 rectal cancer?
OBJECTIVE
Resection combined with standard lymphadenectomy is generally recommended for T2N0 rectal cancer. In order to evaluate the outcome of this specific tumor category, our own data were reviewed.


METHODS
To evaluate the results of patients with curative resected T2N0 rectal carcinoma, we reviewed data of 164 consecutive patients with adenocarcinoma of the rectum between 1981 and 2003 in our department. In addition, patient characteristics were stratified according to the position of the rectal tumor with respect to the anal verge.


RESULTS
One hundred ten patients (67.1%) underwent anterior resection and 54 patients (32.9%) received abdominoperineal amputation. The follow-up revealed 6 local recurrences (3.7%); in 10 patients (10.0%), metastases were discovered. Regarding the tumor localization nearly no local recurrence or distant metastases were observed in the middle or the upper rectum. However, in the lower rectum the actuarial 5-year recurrence rate was 16.2%.


CONCLUSIONS
Although T2N0 rectal carcinomas are considered as low risk tumors, we found a considerable local recurrence rate of 3.7%. The question arises whether this result can be improved by adjuvant treatment modalities without being compromised by the toxicity of an adjuvant treatment.
Petersen
Sven
S
Department of General and Abdominal Surgery, Dresden-Friedrichstadt Hospital, and Teaching Hospital of TU Dresden, Friedrichstrasse 41, D-01067 Dresden, Germany. petersen-sv@khdf.de
Hellmich
Gunter
G
von Mildenstein
Katharina
K
Porse
Gerhard
G
Ludwig
Klaus
K
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D015996:Survival Rate