A comparison of cellular immunity in patients undergoing electrocoagulation and resection for adenocarcinoma of the rectum

Leukocyte migration inhibition assays in patients with carcinoma of the colon and rectum were evaluated in patients treated by electrocoagulation, abdominoperineal resection or low anterior resection and those with Duke's A and B lesions. Assays were performed before treatment, immediately after treatment and two to four months later. No statistically significant differences in cell mediated immunity, measured by leukocyte migration inhibition, were noted between those in the electrocoagulated group and those undergoing resection. However, electrocoagulation does appear to cure some carcinomas of the rectum and does afford a superior quality of survival. It is, however, associated with a higher recurrence rate than resection. Therefore, the decision to use electrocoagulation should not be based upon its effect on immune parameters. Rather, the choice between electrocoagulation, local resection and abdominoperineal resectin is based upon clinical judgment in which the risk of recurrence or metastases must be weighed against a superior quality of survival.