The indication and surgical results of local excision following radiotherapy for low rectal cancer.
Colorectal Dis
; 12(11): 1094-8, 2010 Nov.
Article
em En
| MEDLINE
| ID: mdl-19863609
ABSTRACT
AIM:
Radical surgery of rectal cancer is associated with significant morbidity, and some patients with low-lying lesions must accept a permanent colostomy. The objective of this study was to evaluate the outcome of local excision followed by adjuvant radiotherapy for rectal cancer for curative purposes.METHOD:
One hundred and seven patients with rectal carcinoma performed with local excision were analysed retrospectively.RESULTS:
The procedures of local excision were trans-anal resection in 83 patients, trans-sacral resection in 16, trans-sphincteric local resection in five, and trans-vaginal resection in three. The overall disease-free survival rate was 80.4% (86/107), including 90.0% (54/60) for T1 and 72.3% (34/47) for T2 tumours, respectively. Eighty-two of 107 patients underwent adjuvant postoperative radiotherapy after local excision, and 25 did not, and the DFS rates between radiation and nonradiation group were significantly different for T2 [81.6% (31/38) vs 33.3% (3/9), P < 0.05], but not for T1 tumours (90.9%vs 87.5%, P > 0.05). The rates of local recurrence and distant metastasis were 13.1% (14/107) and 4.7% (5/106), respectively, and the median time to relapse was 15 months (range 10-53) for local recurrence and 30 months (21-65) for distant recurrence. The risk factors for local recurrence were large tumour (≥3 cm), poorly differentiated adenocarcinoma and T2 tumour.CONCLUSIONS:
Local excision followed adjuvant radiotherapy is an alternative and feasible technique for small T1 rectal cancer in selected cases.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Adenocarcinoma
/
Cirurgia Colorretal
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article