Premium
Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10‐year single‐centre experience
Author(s) -
Jones H. J. S.,
Hompes R.,
Mortensen N.,
Cunningham C.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14029
Subject(s) - medicine , microsurgery , surgery , radiation therapy , colorectal cancer , wide local excision , cancer , general surgery
Aim Minimally invasive, organ‐sparing surgery has been used increasingly for early rectal cancer in recent years. However, local recurrence remains a concern. This study presents a 10‐year single‐centre experience of recurrence after local excision for T1 rectal cancer. Method Data were collected prospectively on all patients undergoing local excision by transanal endoscopic microsurgery ( TEM ) in a single institution. Data covering a 10‐year period were analysed. Results In all, 192 patients underwent TEM for rectal cancer; 70 of these had T1 tumour in the TEM specimen and did not have preoperative radiotherapy. Four were managed with completion surgery following TEM and a further six had radiotherapy; 60 underwent surveillance alone. Local recurrence occurred in six patients; three underwent salvage surgery. Estimated local recurrence at 3 years was 7.2% for the surveillance alone group. Conclusions Local recurrence rates were lower than previous studies. Better preoperative assessment, more effective local excision surgery and postoperative radiotherapy may be contributory factors to a better‐than‐predicted outcome. Local excision should be offered as part of standard of care for T1 rectal cancer in the presence of good preoperative selection and meticulous surveillance.