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Related Experiment Video

Updated: Dec 10, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Local excision for T1 rectal tumours: are we getting better?

C Atallah1, J P Taylor1, B D Lo1

  • 1Colorectal Research Unit, Ravitch Colorectal Division, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|September 4, 2020
PubMed
Summary
This summary is machine-generated.

Local excision (LE) for T1 rectal tumors offers similar survival outcomes to radical resection (RR). This approach may reduce surgical morbidity without impacting overall survival, supporting its use in clinical practice.

Keywords:
T1 rectal cancerlocal excisionradical resectiontransanal endoluminal surgerytransanal minimally invasive surgery

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Rectal Cancer Treatment

Background:

  • T1 rectal tumors represent an early stage of rectal cancer.
  • Surgical management options include radical resection (RR) and local excision (LE).
  • The choice of treatment can impact patient survival and surgical morbidity.

Purpose of the Study:

  • To compare the overall survival (OS) rates of three surgical treatments for T1 rectal tumors: radical resection (RR), open local excision (open LE), and laparoscopic local excision (laparoscopic LE).
  • To evaluate the trend in the utilization of LE versus RR over time.
  • To assess the impact of different LE approaches (laparoscopic vs. open) and time periods on survival outcomes.

Main Methods:

  • Analysis of adult patients diagnosed with T1 rectal cancer from the National Cancer Database (2008-2016).
  • Stratification of patients by treatment type: LE versus RR.
  • Subgroup analyses within the LE group based on time period (pre- and post-transanal minimally invasive surgery adoption) and surgical approach (laparoscopic vs. open).
  • Primary outcome was 5-year overall survival (OS).

Main Results:

  • Out of 10,053 patients, 65.88% underwent LE and 34.12% underwent RR.
  • The utilization of LE increased significantly from 2008 to 2016, while RR decreased.
  • No significant difference in 5-year OS was observed between LE and RR groups in both unadjusted and adjusted analyses.
  • Laparoscopic LE showed a trend towards improved OS in unadjusted analysis compared to open LE, but this was not statistically significant in adjusted analysis.

Conclusions:

  • Local excision (LE) is a viable surgical option for T1 rectal tumors, demonstrating comparable overall survival to radical resection (RR).
  • The LE approach can potentially reduce surgical morbidity without compromising long-term survival.
  • Findings support the consideration of LE as a treatment strategy for selected T1 rectal cancer patients.