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Immediatevs. Salvage resection after local treatment for early rectal cancer

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Diseases of the Colon & Rectum

Abstract

PURPOSE: There is an increasing awareness of local procedures to treat early stage rectal cancer. Abdominoperineal resection (APR) or low anterior resection (LAR) has been recommended if adverse pathologic findings are encountered in the local excision specimen. No data compare the impact on survival of “immediate” resection for adverse featuresvs. “salvage” resection for clinical recurrence. METHODS: We reviewed retrospectively 155 patients who underwent initial curative treatment of invasive rectal cancer by excision (91), snare-cautery (44), and fulguration (20). RESULTS: Twenty-one patients underwent APR/LAR immediately after initial local treatment, whereas another 21 patients underwent salvage APR/LAR for local recurrence. The disease-free survival after APR/LAR was 94.1 percent for the immediate group and 55.5 percent for the delayed group (P<0.05). CONCLUSION: This decreased survival observed after delayed resection supports the recommendation for immediate APR/LAR when adverse pathologic features are present in the excision specimen.

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Authors and Affiliations

  1. Department of Surgery, Medical University of South Carolina, 171 Ashley Avenue, 29425, Charleston, South Carolina

    Paul L. Baron M.D. & Warren E. Enker M.D.

  2. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York

    Maureen F. Zakowski M.D. & Carlos Urmacher M.D.

Authors
  1. Paul L. Baron M.D.
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  2. Warren E. Enker M.D.
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  3. Maureen F. Zakowski M.D.
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  4. Carlos Urmacher M.D.
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Baron, P.L., Enker, W.E., Zakowski, M.F. et al. Immediatevs. Salvage resection after local treatment for early rectal cancer. Dis Colon Rectum 38, 177–181 (1995). https://doi.org/10.1007/BF02052447

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