[Management of early rectal cancer: our clinical experience]

Patients with early rectal cancer (ERC) limited to the mucosa and submucosa does not present cytological or histological high risk features such as poorly differentiated cells, vascular and neural invasion, presence of mucinous histology and tumor ulceration. In these patients, local excision of rectal tumors preserves anal continence, bladder and sexual functions and achieves the same oncological results. In T1 patients, local excision is feasible because the curative rate is high (90/95%) and the risk of recurrence that is low ( 5/10%) as reported in the literature. Aim of this study is to carry out the best clinical choice in patients ERC affected. We have examined patologic, laboratory exams and surgical technique performed.

From January 2004 to July 2009, 16 patients with rectal cancer were studied at the General Surgery and Oncology Department of Catania University. The middle size of the cancers at the implantation site were 3,4 cm (range: 3-5). The average distance from the anus were 5,8 cm (range: 4,5-10). The cancers were presented vegetanting and movable on the muscle surfaces below.

Istological exams pointed out pT1 neoplasia confined in submucosa in 13 patients, and in 3 patients pT2 neoplasia with a muscularis mucosae involvement. Istological grading found out G1 neoplasia in 9 cases and G2 in 7. Discussion. Low rectal cancers diagnosed in T1 stage necessitate an accurate preoperatory staging. Local exeresis can be a real alternative to traditional surgery. In these patients neoplasia exeresis can assure 5 years more survival in 85% of patients.

Local exeresis is a validate surgical way but is however necessary that istological exam confirms surgical oncology criteria. Must be confirmed that neoplasia is T1 with 1mm resection margin at least,differentiation G1-G2 and no venous or lymphatic infiltrations.