Suitable T stage for cryosurgery to spare the anus in patients with low rectal cancer

Sphincter preserving therapy is a key research focus for treating low rectal cancer; however, the role of cryotherapy in this process has seldom been reported in the literature. Therefore, we conducted a comprehensive report on the role of cryoablation in sphincter preservation and explored its effect in rectal cancers. An observational study used longitudinal observation and follow-up. Participants were screened from patients whose medical records showed cryotherapy intervention for low rectal cancers from January 2016 to December 2020, with more than 2 years of follow-up. The primary endpoint was progress-free survival, and the secondary outcomes were mainly related to sphincter preservation rate and complications. Thirty-five patients were enrolled in this study, all of whom had their sphincters preserved. Until June 2022, 35 cases achieved long-term progression-free survival (41.77 ± 15.58), with no recurrence observed in 88.57% (31/35) of all patients at follow-up. Cryotherapy showed no significant differences in progress-free survival between sexes (p > 0.05). Cox regression was used to analyze the factors affecting local recurrence, with sex, T stage, size, and cryo-time taken as covariates. The results showed that T stage was a risk factor for local recurrence (p = 0.01, odds ratio: 16.27, 95% confidence interval: 8.20,145.75). Analysis of the T stage according to different subgroups showed that T3 stage was an independent risk factor (p = 0.002). We observed seven cases of complications, which were classified into grades I-II. In patients with low rectal cancers, cryotherapy can safely and effectively preserve the anus and avoid low anterior resection syndrome. Cryoablation has a better curative effect on radical treatment, especially for tumors in the T₀-₂ N₀M₀ stage.