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AIM:To assess the validity of local excision for the earlystage low rectal cancer as an effective treatment alternativeto radical resection.METHODS:A retrospective medical chart review was donein 47 patients with early stage low rectal carcinoma whounderwent local excision from November 1980 throughNovember 1999 at Cancer Hospital of Chinese Academy ofMedical Sciences (CAMS).The patients were treated by eithertransanal (40 cases),trans-sacral (5 cases),or trans-vaginal(2 cases) excision of tumors and no death was related tosurgery.Sixteen patients received postoperative radiotherapy.RESULTS:T1 and T2 lesion was found in 36 (76.6 %) and11 patients (23.4 %) respectively.The overall local tumorrecurrence rate was 14.9 % (7/47),with an averagerecurrence time of 21 months.Among these 7 recurrentpatients,there were 4 T1 and 3 T2 lesions.Microscopically,the surgical incisal margin was negative in 45 (95.7 %) andpositive in 2 patients (4.3 %);Both of the later had developedlocal recurrence.The overall 5-year survival rate was 91.7 %,in which there were 94.4 % for T1 and 83.3 % for T2 tumors.T stage,intravessel tumor thrombosis,lymphocytic infiltrationand histological grade were not found to be significant byrelated to the local recurrence and survival (P>0.05).CONCLUSION:Local tumor excision was a safe procedurefor the treatment of early stage low rectal carcinoma withminimal morbidity and mortality,which might serves as oneof the primary surgical treatment methods for the diseaseof this kind.
AIM: To assess the validity of local excision for the early stage low rectal cancer as an effective treatment alternative to radical resection. METHODS: A retrospective medical chart review was done in 47 patients with early stage low rectal carcinoma whounderwent local excision from November 1980 through November 1999 at Cancer The Hospital of Chinese Academy of Medical Sciences (CAMS). The patients were treated by eithertransanal (40 cases), trans-sacral (5 cases), or trans-vaginal (2 cases) excision of tumors and no death was related tosurgery. postoperative radiotherapy .RESULTS: T1 and T2 lesion was found in 36 (76.6%) and11 patients (23.4%) respectively.The overall local tumor recurrence rate was 14.9% (7/47), with an averagerecurrence time of 21 months .Among these 7 recurrentpatients, there were 4 T1 and 3 T2 lesions. Microscopically, the surgical incisal margin was negative in 45 (95.7%) and positive in 2 patients (4.3%); Both of the later had developed local recurrence. Overall 5-year survival rate was 91.7% in which there 94.4% for T1 and 83.3% for T2 tumors. Stage, intravessel tumor thrombosis, lymphocytic infiltration and histological grade were not found to be significant byrelated to the local recurrence and survival ( P> 0.05). CONCLUSION: Local tumor excision was a safe procedure for the treatment of early stage low rectal carcinoma with minimal morbidity and mortality, which might serves as one of the primary surgical treatment methods for the disease of this kind.