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Surgical management and chemoradiotherapy of T1 rectal cancer
Author(s) -
Kobayashi Hirotoshi,
Sugihara Kenichi
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12068
Subject(s) - medicine , total mesorectal excision , chemoradiotherapy , colorectal cancer , radiation therapy , lymphadenectomy , perioperative , dissection (medical) , surgery , lymph node , general surgery , cancer
T1 rectal cancer can be treated using various strategies. Endoscopic or transanal resection is the first choice of treatment when tumors are not associated with risk for lymph node metastasis. However, transabdominal resection with lymphadenectomy is recommended for tumors that do confer risk of lymph node metastasis. The prognosis after transabdominal resection is satisfactory, but various dysfunctions impair the postoperative quality of life. The standard treatment for T3 – T4 rectal cancer is total mesorectal excision with preoperative chemoradiotherapy in W estern countries and total mesorectal excision with laterallymph node dissection in J apan. Previous reports indicate that preoperative radiotherapy contributes to a lower rate of local recurrence, although overall survival is not affected. In addition, radiotherapy increases the prevalence of sexual dysfunction and fecal incontinence. The effect of perioperative chemoradiotherapy for T1 – T2 rectal cancer remains unclear.