title: Oncological outcomes of transanal local excision for high risk T(1) rectal cancers.
abstract: OBJECTIVE
  To evaluate the oncological outcomes of transanal local excision and the need for immediate conventional reoperation in the treatment of patients with high risk T(1) rectal cancers.
  
  
  METHODS
  Twenty five high risk T(1) rectal cancers treated by transanal local excision at the Guangdong General Hospital were analyzed retrospectively. Twelve patients received transanal local excision and 13 patients underwent subsequent immediate surgical rescue after transanal local excision within 4 wk. Differences in the local recurrence rates and 5-year overall survival rates between the two groups were analyzed. The prognostic value of immediate conventional reoperation for high risk T(1) rectal cancers was also evaluated.
  
  
  RESULTS
  The median follow-up period was 62 mo. The local recurrence rates after transanal local excision for high risk T(1) rectal cancer were 50%. By immediate conventional reoperation, the local recurrence rates were significantly reduced to 7.7%. The difference between these two groups was statistically significant (P = 0.030). Kaplan-Meier survival analysis showed a trend for decreased 5-year overall survival rates for patients treated by transanal local excision compared with immediate conventional reoperation (63% vs 89%).
  
  
  CONCLUSIONS
  Transanal local excision cannot be considered sufficient treatment for patients with high risk T(1) rectal cancers. Immediate conventional reoperation should be performed if the pathology of the local excision is high risk.
authors.affiliation: Ze-Yu Wu, Gang Zhao, Zhe Chen, Jia-Lin Du, Jin Wan, Feng Lin, Lin Peng, Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Ze-Yu
authors.initials: ZY
authors.lastname: Wu
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.forename: Zhe
authors.initials: Z
authors.lastname: Chen
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Du
authors.forename: Jin
authors.initials: J
authors.lastname: Wan
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Lin
authors.initials: L
authors.lastname: Peng