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Related Experiment Videos

Local excision for rectal cancer.

A Balani1, A Turoldo, A Braini

  • 1Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Universitè degli Studi di Trieste, Italy. a.balani@fmc.univ.trieste.it

Journal of Surgical Oncology
|July 29, 2000
PubMed
Summary

Local excision (LE) for early-stage rectal cancer offers survival rates comparable to traditional surgery. Careful patient selection and preoperative staging are crucial for successful LE outcomes, minimizing specific morbidity.

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastrointestinal Oncology

Background:

  • Rectal cancer treatment historically involves radical surgery.
  • Local excision (LE) is an alternative for select early-stage rectal cancers.
  • Evaluating LE outcomes is essential for refining treatment strategies.

Purpose of the Study:

  • To assess the efficacy and safety of local excision (LE) for curative rectal cancer treatment.
  • To compare LE outcomes with traditional radical surgical procedures.
  • To identify criteria for successful LE in rectal cancer patients.

Main Methods:

  • Retrospective analysis of 456 rectal cancer surgeries from 1969-1997.
  • Inclusion criteria for LE: T1-T2, N0, M0 tumors, G1-G2 grade, accessible location.

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  • LE techniques included transanal excision, Mason surgery, endoscopic excision, and transanal endoscopic microsurgery.

    • Main Results:

    • No in-hospital mortality in the 20 LE patients.
    • Five-year overall survival for LE was 87.4%, comparable to abdominoperineal resection (APR) and sphincter-saving resection (SSR) (88.3%).
    • LE showed significantly lower specific morbidity (P=0.007) compared to APR/SSR, with no local recurrences observed.

    Conclusions:

    • Local excision (LE) is a viable option for carefully selected rectal cancer patients.
    • Accurate preoperative staging is paramount for successful LE.
    • LE demonstrated comparable survival and reduced specific morbidity versus radical surgery in this cohort.