Clinical results and prognostic analysis of local excision in lower rectal cancer / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the results and the prognosis of local excision of lower rectal cancer, and investigate the proper indication of local excision for cure purpose.</p><p><b>METHODS</b>The clinicopathological data of 76 patients with lower rectal cancer treated from February 1985 to October 2007 were analyzed.</p><p><b>RESULTS</b>Sixty-nine patients received transanal excision, 6 cases received trans-sacral excision and 1 case received trans-vaginal excision. Among the cases, 48 cases were ranged as T1 phase, 25 cases as T2, 3 cases as T3. The operation complication rate was 7.9%, and the 30-day mortality rate post operation was 0. The local recurrence rate was 22.4% and the overall 5 year survival rate was 84.5%. The local recurrence was significantly related with T stage and resection margin status. The survival was significantly related with mucinous adenocarcinoma, resection margin status and lymphovascular invasion; and the resection margin and lymphovascular invasion was the independent factors affecting survival.</p><p><b>CONCLUSION</b>Local excision was safe in early stage lower rectal cancer. Careful patient selection is the key of the operation. The proper indication of local excision is T1-2 without high risk factors (high histopathological grade, presence of lymphatic or vascular invasion, mucinous adenocarcinoma); and the cases with T2 phase tumor should undergo chemoradiotherapy after local excision.</p>