title: Long-term outcome of early-stage rectal cancer undergoing standard resection and local excision.
abstract: OBJECTIVE
  To explore the long-term outcome and prognostic factors for early stage rectal cancer patients undergoing standard resection (SR) or local excision (LE).
  
  
  METHODS
  This study included 350 patients with stage I rectal cancer, in which 283 cases (80.9%) received SR, and 67 cases (19.1%) received LE. Survival analyses were performed to compare outcomes of different surgeries.
  
  
  RESULTS
  The 5-year local recurrence (LR) rate was 14.1% in LE group versus 3.3% in SR group (P= .0004), and the 10-year overall survival (OS) rate was not significantly different between the 2 groups. Multivariate analysis suggested that LE was an independent risk factor for 5-year LR rate and 10-year OS rate. Tumor grade was found related to 5-year LR, and T stage was found related to 10-year OS. Tumor size of 2.5 cm is found as a possible cut-off for predicting 5-year LR rate in LE group, with a sensitivity of 77.8% and a specificity of 75.9%. In patients with LE, the 5-year LR rate for tumors ≥ 2.5 cm was 40%, compared with 4.3% for tumors < 2.5 cm (P = .001).
  
  
  CONCLUSIONS
  Local excision in early-stage rectal cancer may result in high local recurrence rate. The procedure is only recommended in highly selective groups of patients. A tumor size of 2.5 cm is a useful criterion for choosing LE rather than SR.
authors: Department of Colorectal Surgery, Cancer Hospital Fudan University, Department of Oncology, Shanghai Medical College, Fudan University, People's Republic of China.
authors: Junjie
authors: J
authors: Peng
authors: Wei
authors: W
authors: Chen
authors: Alan P
authors: AP
authors: Venook
authors: Weiqi
authors: W
authors: Sheng
authors: Ye
authors: Y
authors: Xu
authors: Zuqing
authors: Z
authors: Guan
authors: Guoxiang
authors: G
authors: Cai
authors: Sanjun
authors: S
authors: Cai