[Local therapy of early rectal carcinoma with curative intent: implications for a change in oncologic strategy]

Patients with pT1 low-risk rectal carcinomas seem to be overtreated by a classical radical operation. A total of 170 patients with rectal carcinomas were locally treated with the transanal endoscopic microsurgery (TEM) technique. Four of the group with pT1 low-risk tumours with local therapy developed a recurrence, three of whom underwent a curative secondary procedure, bringing the failure rate to one out of 81. Two recurrences were diagnosed among the 22 patients who were re-resected after local treatment in stage pT1 low risk. Both patients died of the tumour disease, another due to dehiscence of the suture, bringing the failure rate in the re-resected group to three of 22.