Abstract
A safe, simple technique of curative local excision is used for early invasive carcinoma of the rectum. Strict criteria were applied in selecting patients for curative local excision: (1) the tumor was less than 3cm in diameter; (2) there were no clinically involved pelvic lymph nodes; (3) the tumor had a pedicle or pseudopedicle, and (4) subsequent histopathologic examination showed that the tumor was confined to the mucosa and submucosa of the bowel wall and completely excised. Curative local excision in 16 patients had no operative mortality or morbidity. The five-year cancer specific survival was 100 per cent, which compares favorably with the 88 per cent cancer specific survival rate in 268 patients managed by conventional curative resection for Dukes' stage A tumors. When the 7.1 per cent operative mortality of resection was additionally considered, the five-year survival fell to 81 per cent. The probability of lymph-node metastases in primary rectal tumors confined to the mucosa and submucosa was found to be 6.2 per cent irrespective of their diameter,i.e., slightly less than the mortality of resection.
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References
Cuthbertson AM, Kaye AH. Local excision of carcinomas of the rectum, anus, and anal canal. Aust NZ J Surg 1978;48:412–5.
Lock MR, Cairns DW, Ritchie JK, Lockhart-Mummery HE. The treatment of early colorectal cancer by local excision. Br J Surg 1978;65:346–9.
Mason AY. The place of local resection in the treatment of rectal carcinoma. Proc R Soc Med 1970;63:1259–62.
Morson BC, Bussey JH, Samoorian S. Policy of local excision for early cancer of the colorectum. Gut 1977;18:1045–50.
Dukes CE. The pathology of rectal cancer. In: Smithers I, ed. Neoplastic disease at various sites: cancer of the rectum. Edinburgh: Livingstone, 1960:3–59.
Kaplan EL, Meier P. Non-parametric estimation from incomplete observations. J Am Statist Assoc 1958;53:457–81.
Hughes ES, McDermott FT, Masterton JP, Cunningham IG, Polglase AL. Operative mortality following excision of the rectum. Br J Surg 1980;67:49–51.
Pihl EA, Hughes ES, McDermott FT, Milne BJ, Korner JM, Price AB. Carcinoma of the rectum and rectosigmoid: cancer specific long-term survival. A series of 1061 cases treated by one surgeon. Cancer 1980;45:2902–7.
Kodaira S, Teramoto T, Ono S, Takizawa K, Katsumata T, Abe O. Lymph node metastases from carcinomas developing in pedunculated and semipedunculated colorectal adenomas. Aust NZ J Surg 1981;51:429–33.
Mason AY. Selective surgery for carcinoma of the rectum. Aust NZ J Surg 1976;46:322–9.
Morson BC. Factors influencing the prognosis of early cancer of the rectum. Proc R Soc Med 1966;59:607–8.
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Supported by a grant from the Anti-Cancer Council of Victoria.
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Grigg, M., McDermott, F.T., Pihl, E.A. et al. Curative local excision in the treatment of carcinoma of the rectum. Dis Colon Rectum 27, 81–83 (1984). https://doi.org/10.1007/BF02553979
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DOI: https://doi.org/10.1007/BF02553979