The role of surgical local excision in the treatment of rectal cancer
- 1 September 1985
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 72 (9), 694-697
- https://doi.org/10.1002/bjs.1800720908
Abstract
Selection of patients with ulcerating rectal cancer for treatment by local excision has been governed by a policy based on clinical and histological criteria; if these criteria are not fulfilled, major resection is recommended. This policy was re-examined in three groups of patients treated by local excision: Group 1 for cure (27 patients), Group 2 due to unfitness for major surgery (13 patients), Group 3 for local tumour control in the presence of metastatic disease (6 patients). When the policy was fulfilled, there was a cancer-specific death rate of 8.3 per cent in Group 1 (two patients with poorly differentiated tumours) and 0 per cent in Group 2. Unavoidable policy breaches occurred when patients refused major surgery or were too unfit: in the latter elderly group, this did not have the adverse effect expected. It is concluded that pre-operative clinical digital assessment and histological grading are a satisfactory means of identifying a small group of tumours appropriate for local treatment and that the results justify local excision where the policy is observed.Keywords
Funding Information
- Cancer Research Campaign
- Mark's Research Foundation
This publication has 11 references indexed in Scilit:
- Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy.Gut, 1984
- Local excision of cancer of the rectumDiseases of the Colon & Rectum, 1983
- Importance of patient selection in local treatment of carcinoma of the rectumThe American Journal of Surgery, 1983
- Local excision of low and mid-rectal villous adenomasThe American Journal of Surgery, 1982
- The clinical staging of rectal cancerBritish Journal of Surgery, 1982
- The treatment of early colorectal cancer by local excisionBritish Journal of Surgery, 1978
- The survival of patients with colorectal cancer treated in a regional hospitalBritish Journal of Surgery, 1978
- Policy of local excision for early cancer of the colorectum.Gut, 1977
- The results of surgical treatment for carcinoma of the rectum at St Mark's Hospital from 1948 to 1972British Journal of Surgery, 1976
- Intracavitary irradiation of early rectal cancer for cureA series of 186 casesCancer, 1975