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Sphincter preservation of leiomyosarcoma of the rectum and anus with local excision and brachytherapy

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: The aim of this study was to determine the outcome of patients with leiomyosarcoma of the rectum or anus treated with local excision and brachytherapy. METHODS: Eight patients with leiomyosarcoma of the rectum (7 patients) or anus (1 patient) were treated with a transanal excision followed by a temporary iridium-192 interstitial implant to 4,500 cGy. Median tumor size was 4.2 (range, 1.5–5) cm. Margins were positive in six patients, negative in one patient, and close in one patient. RESULTS: With a median follow-up of 53 months, median survival time was 53 months and the three-year actuarial survival rate was 71 percent. The cumulative incidence of failure as a component of failure for local was 25 percent (2/8), for abdominal was 0 percent (0/8), and for distant was 25 percent (2/8). Four patients eligible for functional analysis all had excellent sphincter function (1–2 bowel movements per day, no soilage). CONCLUSION: In selected patients the use of conservative surgery followed by brachytherapy is a reasonable alternative to an abdominoperineal resection. However, more experience and longer follow-up are needed before this approach can be recommended routinely.

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Authors and Affiliations

  1. From the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York

    Alison Grann M.D. & Bruce D. Minsky M.D.

  2. Colorectal Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York

    Philip B. Paty M.D., Jose G. Guillem M.D. & Alfred M. Cohen M.D.

Authors
  1. Alison Grann M.D.
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  2. Philip B. Paty M.D.
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  3. Jose G. Guillem M.D.
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  4. Alfred M. Cohen M.D.
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  5. Bruce D. Minsky M.D.
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Grann, A., Paty, P.B., Guillem, J.G. et al. Sphincter preservation of leiomyosarcoma of the rectum and anus with local excision and brachytherapy. Dis Colon Rectum 42, 1296–1299 (1999). https://doi.org/10.1007/BF02234218

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  • DOI: https://doi.org/10.1007/BF02234218

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