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Recurrences after local excision for early rectal adenocarcinoma

Authors
 Jung Wook Huh  ;  Yoon Ah Park  ;  Kang Young Lee  ;  Seong Ah Kim  ;  Seung-Kook Sohn 
Citation
 YONSEI MEDICAL JOURNAL, Vol.50(5) : 704-708, 2009 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2009
MeSH
Adenocarcinoma/pathology* ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology* ; Neoplasm Recurrence, Local/surgery ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/surgery ; Retrospective Studies ; Risk Factors ; Salvage Therapy ; Time Factors ; Treatment Outcome
Keywords
Recurrence ; local excision ; rectal adenocarcinoma
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.
Files in This Item:
T200905809.pdf Download
DOI
10.3349/ymj.2009.50.5.704
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seong Ah(김성아)
Park, Yoon Ah(박윤아)
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105918
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