Current status of local treatment for early rectal cancer in Japan: a questionnaire survey by the 81st Congress of the Japanese Society for Cancer of the Colon and Rectum (JSCCR) in 2014.
OBJECTIVE
The aim of this questionnaire survey was to assess the change in treatment modality over time and the current status of clinical outcomes of local treatment in Japanese patients with pathological T1 (pT1) rectal tumors.


METHODS
A questionnaire survey was conducted by the 81st Congress of the Japan Society for Cancer of the Colon and Rectum. Clinical and pathological outcomes of all eligible patients undergoing local treatment were retrospectively collected from the medical records of each participating hospital.


RESULTS
A total of 1371 pT1 patients from January 2006 to December 2008 (Period A), and 659 patients in 2013 (Period B) were registered. Approximately 70 % of patients underwent radical surgery in both periods. The rate of patients undergoing laparoscopic surgery increased from 46.5 % in Period A to 84.7 % in Period B. The indications for local excision were comparable with those for endoscopic intervention in 78 % of institutions. The rate of endoscopic submucosal dissection (ESD) increased from 20.1 % in Period A to 37.9 % in Period B, whereas local excision decreased from 36.9 to 24.1 %. Few patients received adjuvant therapy, and approximately 40 % of patients underwent additional surgery in both periods. Local recurrence was observed in 9.2 % of patients in Period A, with the median follow-up period being 59 months. Eighty-two percent of patients with local recurrence underwent salvage surgery.


CONCLUSIONS
Local treatment with various modalities was properly performed for early rectal cancer. The number of less invasive modalities, such as laparoscopic surgery and ESD, increased between study periods.
Department of Surgery, Fujita Health University, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan. katsuno@fujita-hu.ac.jp.
Hidetoshi
H
Katsuno
Department of Surgery, Fujita Health University, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Koutarou
K
Maeda
Department of Surgery, Fujita Health University, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Tsunekazu
T
Hanai
Department of Surgery, Fujita Health University, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Yoshikazu
Y
Koide
Department of Surgery, Fujita Health University, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Hiroshi
H
Matsuoka
Tokyo Medical and Dental University, Tokyo, Japan.
Kenichi
K
Sugihara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000639:trends; D004210:Dissection / Q000639:trends; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007564:Japan; D010535:Laparoscopy / Q000639:trends; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D016879:Salvage Therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Early rectal cancer; Endoscopic mucosal dissection; Minimally invasive transanal surgery; Questionnaire; Transanal endoscopic microsurgery