Transanal local excision of selected low rectal cancers

Area of Science:

• Colorectal Surgery
• Oncology
• Radiation Oncology

Background:

• Transanal local excision (TALE) is a minimally invasive option for early low rectal cancer.
• The role of adjuvant radiotherapy following TALE requires further clarification.

Purpose of the Study:

• To evaluate TALE as an alternative to radical resection for selected early low rectal cancers.
• To determine the necessity and efficacy of adjuvant radiotherapy in patients treated with TALE.

Main Methods:

• Retrospective analysis of 47 patients who underwent TALE for low rectal cancer and were considered for radiotherapy.
• Comparison of local recurrence rates and survival outcomes between irradiated and unirradiated patient groups.

Main Results:

• Local recurrence rates were 26% (T1), 29% (T2), and 67% (T3).
• Adjuvant radiotherapy was associated with a significantly lower local recurrence rate (13% vs. 46%, P = 0.023) and improved 5-year recurrence-free survival (81% vs. 52%, P = 0.025).
• Salvage resection was performed in 7 patients, with 3 achieving no evidence of disease.

Conclusions:

• Transanal local excision combined with adjuvant radiotherapy is an effective treatment for selected low rectal cancers.
• This combined approach offers a viable alternative to radical resection, achieving low recurrence rates.