Advertisement

World Journal of Surgery

, Volume 26, Issue 9, pp 1170–1174 | Cite as

Long-term Results of Patients with pT2 Rectal Cancer Treated with Radiotherapy and Transanal Endoscopic Microsurgical Excision

  • Emanuele Lezoche
  • Mario Guerrieri
  • Alessandro M. Paganini
  • Francesco Feliciotti
Article

Abstract

Anterior resection and abdomino-perineal resection are the surgical techniques used most frequently in the treatment of rectal cancer. Local recurrence rates of 10% to 14% are described after these conventional procedures. Preoperative neoadjuvant radiotherapy reduces local failure. Because local excision techniques can be applied to treat early rectal cancer in selected patients, we evaluated the results of preoperative high-dose radiotherapy and transanal endoscopic microsurgical excision (TEM) in patients with T2 rectal cancer. All patients underwent preoperative irradiation with 5,040 cGy, divided over 5 weeks. Fourty days after completion of radiotherapy, the patients underwent complete full-thickness local excision of the rectal lesion including adjacent perirectal fat by TEM. The patients were followed for up to 8 years. Thirty-five patients, with pT2 rectal cancer as determined by pathological examination of the surgical specimen were enrolled in the present study. The tumors were responsive to preoperative radiotherapy in 82.8% of cases. No intraoperative complications and no conversion to open surgery were observed. No major complications and no mortality occurred during the 60-day postoperative period. Minor postoperative complications were observed in 5 patients (14.3%). The median follow-up of the patients was 38 months (range 24 to 96 months). One local recurrence (2.85%) was noted. The probability of surviving at 96 months after completion of treatment was 83%. Local excision by TEM combined with preoperative high-dose radiotherapy can achieve results similar to those observed after conventional surgery in patients with pT2 rectal cancer.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Société Internationale de Chirurgie 2002

Authors and Affiliations

  • Emanuele Lezoche
    • 1
  • Mario Guerrieri
    • 2
  • Alessandro M. Paganini
    • 2
  • Francesco Feliciotti
    • 2
  1. 1.II Clinica Chirurgica, Department of Surgery "P. Stefanini," University of Roma "La Sapienza," Viale del Policlinico 155, 00161 Roma, ItalyITALY
  2. 2.Clinica di Chirurgia Generale, Umberto I Hospital, University of Ancona, Piazza Cappelli 1, 60121 Ancona, ItalyITALY

Personalised recommendations