Recurrences after Local Excision for Early Rectal Adenocarcinoma.
10.3349/ymj.2009.50.5.704
- Author:
Jung Wook HUH
1
;
Yoon Ah PARK
;
Kang Young LEE
;
Seong Ah KIM
;
Seung Kook SOHN
Author Information
1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Gwangju, Korea.
- Publication Type:Original Article
- Keywords:
Recurrence;
rectal adenocarcinoma;
local excision
- MeSH:
Adenocarcinoma/*pathology/surgery;
Adult;
Aged;
Aged, 80 and over;
Female;
Humans;
Male;
Middle Aged;
Neoplasm Recurrence, Local/epidemiology/*pathology/surgery;
Rectal Neoplasms/*pathology/surgery;
Retrospective Studies;
Risk Factors;
Salvage Therapy;
Time Factors;
Treatment Outcome
- From:Yonsei Medical Journal
2009;50(5):704-708
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The role of local excision in treating rectal cancer patients continues to be controversial. The aim of this study was to evaluate the long-term oncological results of local excision for early rectal adenocarcinomas and review the outcomes of salvage therapy on rectal cancer patients. MATERIALS AND METHODS: Between March 1992 and September 2005, 35 consecutive patients with early-stage primary rectal adenocarcinomas were treated by local excision with curative intent. The mean tumor distance from the anal verge was 5 cm (range, 1-10 cm). RESULTS: The median follow-up was 66 months (range, 17-161 months). Pathological examination revealed 23 cases of T1 and 12 cases of T2. Recurrence had developed in 10 patients (6 local recurrences, 4 systemic recurrences). Purely extrapelvic recurrence was observed in only two (5.7%) patients. Of the eight recurrent patients with surgical salvage, five survived with no evidence of disease at the time of this analysis. The 5-year local recurrence-free and disease-free survival rates were 79.6% and 67.9%, respectively. CONCLUSION: Local excision alone of early-staged rectal adenocarcinomas, even in the ideal candidate, is followed by a relatively higher local recurrence rate than previously reported and may not be a valid modality. Either the use of adjuvant therapy with local excision, even in patients with T1 lesions or the use of preoperative therapy followed by local excision has good promise.
