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Updated: Aug 9, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Is surgery-only the adequate treatment approach for T2N0 rectal cancer?
Sven Petersen1, Gunter Hellmich, Katharina von Mildenstein
1Department of General and Abdominal Surgery, Dresden-Friedrichstadt Hospital, and Teaching Hospital of TU Dresden, Friedrichstrasse 41, D-01067 Dresden, Germany. petersen-sv@khdf.de
Background And Objectives:
Resection combined with standard lymphadenectomy is generally recommended for T2N0 rectal cancer. In order to evaluate the outcome of this specific tumor category, our own data were reviewed.
Methods:
To evaluate the results of patients with curative resected T2N0 rectal carcinoma, we reviewed data of 164 consecutive patients with adenocarcinoma of the rectum between 1981 and 2003 in our department. In addition, patient characteristics were stratified according to the position of the rectal tumor with respect to the anal verge.
Results:
One hundred ten patients (67.1%) underwent anterior resection and 54 patients (32.9%) received abdominoperineal amputation. The follow-up revealed 6 local recurrences (3.7%); in 10 patients (10.0%), metastases were discovered. Regarding the tumor localization nearly no local recurrence or distant metastases were observed in the middle or the upper rectum. However, in the lower rectum the actuarial 5-year recurrence rate was 16.2%.
Conclusions:
Although T2N0 rectal carcinomas are considered as low risk tumors, we found a considerable local recurrence rate of 3.7%. The question arises whether this result can be improved by adjuvant treatment modalities without being compromised by the toxicity of an adjuvant treatment.
