Prospective evaluation of local excision for small rectal cancers.

摘要: OBJECTIVE: Most data on local excisions for rectal cancer are based retrospective studies. We review the results of a prospective registry patients eligible excision using transanal, transsphincteric, or transcoccygeal technique combined with multimodality therapy lesions penetrating muscularis propria (T2) perirectal fat (T3). METHODS: Patients less than 4 cm in diameter and 10 from dentate line, no evidence distant metastases invasion into fat, were excision. greater (T3) received adjuvant chemoradiation therapy. RESULTS: Forty-eight have been followed prospectively. Average age is 63 years. Thirty-three underwent transanal Fifteen either transsphincteric There was perioperative mortality. Pathology revealed 1 Tis, 21 T1, T2, 5 T3 cancers. Mean follow-up 40.5 months. Cancerrelated overall mortality percent. Overall recurrence rate 8 percent(4/48). Recurrence appeared to be related presence positive margin aggressive histology (lymphatic invasion). Local recurrences treated salvage CONCLUSION: can used selectively small cancers, minimum morbidity. rates low (8 percent). lymphatic need considered further therapy, including abdominoperineal resection, even T1 lesions. Adjuvant appears benefit all T2