ABSTRACT
OBJECTIVE: To analyze early and long-term outcomes after total mesorectal excision (TME) and transanal endoscopic microsurgery (TEM) in patients with T1 rectal cancer. MATERIAL AND METHODS: A retrospective non-randomized comparative study included 2 groups of patients: group 1 - total mesorectal excision, group 2 - transanal endoscopic microsurgery. In the second group, total mesorectal excision was proposed for patients with tumor invasion depth pT1sm3 and/or lymphovascular invasion and/or low differentiation. If total mesorectal excision was performed as a salvage surgery, the patient was excluded from further analysis. RESULTS: There were 156 patients with rectal adenocarcinoma pT1 between October 2011 and August 2019 (102 cases - TEM, 54 cases - TME). We excluded 10 patients from the TEM group due to salvage surgery. Duration of TEM was 40.0 (34; 50) min, TME - 139 (120; 180) min (p=0.00001). Postoperative hospital-stay was also significantly less in the TEM group (7 (6; 9) vs. 10 (7; 11) days, p=0.00001). Six (6.5%) patients in the TEM group and 1 (1.8%) patient in the TME group developed a local recurrence in pelvic cavity (p=0.1). There were no distant metastases. Disease-free 3-year survival was 92% after TEM and 96% after TME (p=0.058). CONCLUSION: Transanal endoscopic microsurgery is a relatively safe alternative to total mesorectal excision for early rectal cancer.
Subject(s)
Adenocarcinoma , Rectal Neoplasms , Transanal Endoscopic Microsurgery , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Humans , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Retrospective Studies , Salvage Therapy , Transanal Endoscopic Microsurgery/adverse effects , Transanal Endoscopic Microsurgery/methodsABSTRACT
Turcot syndrome is a rare hereditary syndrome characterized by a combination of brain tumors and colorectal cancer. According to the literature, about 150 such cases have been reported. This article presents a rare clinical case and a literature review.
Subject(s)
Brain Neoplasms , Colorectal Neoplasms , Gardner Syndrome , Brain Neoplasms/diagnosis , Colorectal Neoplasms/diagnosis , Female , Gardner Syndrome/diagnosis , Humans , Neoplastic Syndromes, Hereditary/diagnosisABSTRACT
AIM: To identify risk factors of lymph node metastases in patients with pT1 rectal cancer. MATERIAL AND METHODS: There were 43 patients aged 62.3±11.3 years with pT1 rectal cancer who underwent mesorectal excision in 2012 - 2018. There were 34 (64%) females and 19 (36%) males. RESULTS: Histological examination revealed SM1-2 in 22/43 (51%) cases, SM3 - in 21/43 (49%) cases. Lymph node metastases were identified in specimens with submucosal invasion: SM3 - in 8/21 (38.1%) cases and SM1-2 - in 3/22 (13.6%) cases (p=0.08). Logistic regression confirmed lymphovascular invasion (p=0.005) and mucosal and/or poorly differentiated carcinoma (p=0.014) as independent predictors of lymph node metastases. CONCLUSION: Lymphovascular invasion and poorly differentiated carcinoma are indications for transabdominal mesorectal excision.
Subject(s)
Lymph Nodes/pathology , Rectal Neoplasms/pathology , Aged , Female , Humans , Lymph Node Excision , Lymphatic Metastasis , Male , Mesentery/pathology , Mesentery/surgery , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Rectal Neoplasms/surgery , Risk FactorsABSTRACT
Kidney metastasis in colorectal cancer are rare. A number of publications dedicated to this topic is quite limited. In this article a rare observation of metastasis of colorectal cancer to the kidney is described.