Recurrences after Local Excision for Early Rectal Adenocarcinoma

다국어 초록 (Multilingual Abstract)

Purpose: The role of local excision in treating rectal cancer patients continues to be controversial. The aim of this
study was to evaluate the long-term oncological results of local excision for early rectal adenocarcinomas and
review the outcomes of salvage therapy on rectal cancer patients. Materials and Methods: Between March 1992
and September 2005, 35 consecutive patients with early-stage primary rectal adenocarcinomas were treated by local
excision with curative intent. The mean tumor distance from the anal verge was 5 cm (range, 1-10 cm). Results:
The median follow-up was 66 months (range, 17-161 months). Pathological examination revealed 23 cases of T1
and 12 cases of T2. Recurrence had developed in 10 patients (6 local recurrences, 4 systemic recurrences). Purely
extrapelvic recurrence was observed in only two (5.7%) patients. Of the eight recurrent patients with surgical
salvage, five survived with no evidence of disease at the time of this analysis. The 5-year local recurrence-free and
disease-free survival rates were 79.6% and 67.9%, respectively. Conclusion: Local excision alone of early-staged
rectal adenocarcinomas, even in the ideal candidate, is followed by a relatively higher local recurrence rate than
previously reported and may not be a valid modality. Either the use of adjuvant therapy with local excision, even in
patients with T1 lesions or the use of preoperative therapy followed by local excision has good promise.

다국어 초록 (Multilingual Abstract)

Purpose: The role of local excision in treating rectal cancer patients continues to be controversial. The aim of this
study was to evaluate the long-term oncological results of local excision for early rectal adenocarcinomas and
review the outcomes of salvage therapy on rectal cancer patients. Materials and Methods: Between March 1992
and September 2005, 35 consecutive patients with early-stage primary rectal adenocarcinomas were treated by local
excision with curative intent. The mean tumor distance from the anal verge was 5 cm (range, 1-10 cm). Results:
The median follow-up was 66 months (range, 17-161 months). Pathological examination revealed 23 cases of T1
and 12 cases of T2. Recurrence had developed in 10 patients (6 local recurrences, 4 systemic recurrences). Purely
extrapelvic recurrence was observed in only two (5.7%) patients. Of the eight recurrent patients with surgical
salvage, five survived with no evidence of disease at the time of this analysis. The 5-year local recurrence-free and
disease-free survival rates were 79.6% and 67.9%, respectively. Conclusion: Local excision alone of early-staged
rectal adenocarcinomas, even in the ideal candidate, is followed by a relatively higher local recurrence rate than
previously reported and may not be a valid modality. Either the use of adjuvant therapy with local excision, even in
patients with T1 lesions or the use of preoperative therapy followed by local excision has good promise.

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