Outcomes of Local Excision for Early Rectal Cancer: a 6-year Experience from the Largest University Hospital in Thailand
Open Access
- 30 September 2013
- journal article
- Published by Asian Pacific Organization for Cancer Prevention in Asian Pacific Journal of Cancer Prevention
- Vol. 14 (9), 5141-5144
- https://doi.org/10.7314/apjcp.2013.14.9.5141
Abstract
This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.Keywords
This publication has 16 references indexed in Scilit:
- Transanal Minimally Invasive Surgery (TAMIS) for Local Excision of Benign Neoplasms and Early-stage Rectal CancerDiseases of the Colon & Rectum, 2013
- ESMO Consensus Guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision makingAnnals of Oncology, 2012
- Management and Outcome of Local Recurrence Following Transanal Endoscopic Microsurgery for Rectal CancerDiseases of the Colon & Rectum, 2012
- Transanal Endoscopic Microsurgery Versus Conventional Transanal Excision for Patients With Early Rectal CancerAnnals of Surgery, 2009
- Transanal endoscopic microsurgery for rectal tumors: experience at Korea’s National Cancer CenterSurgical Endoscopy, 2009
- Outcomes of Sphincter-Saving Operation for Rectal Cancer without Protective Stoma and Pelvic Drain, and Risk Factors for Anastomotic LeakageDigestive Surgery, 2008
- Early Rectal Cancer: Local Excision or Radical Surgery?Journal of Surgical Education, 2008
- Is the Increasing Rate of Local Excision for Stage I Rectal Cancer in the United States Justified?Annals of Surgery, 2007
- T1 Adenocarcinoma of the RectumAnnals of Surgery, 2005
- Long-Term Results of Local Excision for Rectal CancerAnnals of Surgery, 2002