Long-term oncological and functional outcomes of transanal full-thickness resection after non-curative local resection of early rectal cancer / 中华普通外科杂志

ABSTRACT

Objective:To explore the safety of transanal re-excision (TAR) after positive-margin local resection for early rectal cancer.Methods:A retrospective analysis was made data of 44 patients with rectal cancer after local excision from Mar 2006 to Oct 2018 at the Department of Colorectal Surgery, Cancer Hospital of Chinese Academy of Medical Sciences. All patients had positive margin or suspicious tumor remains after local excision, and subsequently salvage TAR surgery was performed after informed consent was given.Results:Forty-four patients after local excision were with pathologically showed residual condition, including 26 cases of positive margin and 18 cases of suspicious tumor remaining. The pathological types were all adenocarcinoma. Forty-one (93%) patients with pT1 and 3 (7%) patients with pT2. The median follow-up time after salvage TAR was 100 (11-164) months. During follow-up, 3 patients (7%) developed mild anal incontinence. One patient (2%) had local recurrence, 3 (7%) patients had distant metastases, and 3 patients (7%) died of non-tumor specific deaths. The overall 5-year survival rate and disease-free survival rate were 98% and 93 %, respectively.Conclusions:Transannal full thickness tumor re-excision is safe and reliable for the salvage treatment after non-complete local resection of early rectal cancer. The long-term follow-up results show that the 5-year survival rate is comparable to that of radical surgical resection, and with a good anal function.