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Long-term outcome of early-stage rectal cancer undergoing standard resection and local excision.
MedLine Citation:
PMID:  21609934     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives: To explore the long-term outcome and prognostic factors for early stage rectal cancer patients undergoing standard resection (SR) or local excision (LE).Patients and Methods: This study included 350 patients with stage I rectal cancer, in which 283 cases (80.9%) received SR, and 67 cases (19.1%) received LE. Survival analyses were performed to compare outcomes of different surgeries. Results: The 5-year local recurrence (LR) rate was 14.1% in LE group versus 3.3% in SR group (P= .0004), and the 10-year overall survival (OS) rate was not significantly different between the 2 groups. Multivariate analysis suggested that LE was an independent risk factor for 5-year LR rate and 10-year OS rate. Tumor grade was found related to 5-year LR, and T stage was found related to 10-year OS. Tumor size of 2.5 cm is found as a possible cut-off for predicting 5-year LR rate in LE group, with a sensitivity of 77.8% and a specificity of 75.9%. In patients with LE, the 5-year LR rate for tumors ≥ 2.5 cm was 40%, compared with 4.3% for tumors < 2.5 cm (P = .001). Conclusion: Local excision in early-stage rectal cancer may result in high local recurrence rate. The procedure is only recommended in highly selective groups of patients. A tumor size of 2.5 cm is a useful criterion for choosing LE rather than SR.
Authors:
Junjie Peng; Wei Chen; Alan P Venook; Weiqi Sheng; Ye Xu; Zuqing Guan; Guoxiang Cai; Sanjun Cai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical colorectal cancer     Volume:  10     ISSN:  1938-0674     ISO Abbreviation:  Clin Colorectal Cancer     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-05-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101120693     Medline TA:  Clin Colorectal Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-41     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, Department of Oncology, Cancer Hospital Fudan University, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
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