Document Detail


Outcome of transanal endoscopic microsurgery and adjuvant radiotherapy in patients with T2 rectal cancer.
MedLine Citation:
PMID:  18236108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The use of transanal endoscopic microsurgery for local excision of rectal cancer has recently gained wide acceptance as a valid and safe alternative for the surgical treatment of T1 tumors. The adequacy of such treatment for T2 tumors, however, is still controversial. This study was designed to evaluate our results with local excision of T2 cancers. METHODS: Patients with T2 cancer admitted to our hospital between 1995 and 2005 were offered surgery by transanal endoscopic microsurgery if found medically unfit or were unwilling to undergo radical surgery. Patients who were preoperatively staged as T1 tumor but were found to be pathologically T2 also were included. RESULTS: Overall, we performed 59 transanal endoscopic microsurgery operations for rectal cancers, of which 21 were for T2 cancers. In 16 (76 percent) of the T2 patients, the tumors were completely removed with clear margins by transanal endoscopic microsurgery and no additional surgery was performed, except for 2 patients who developed radiation-induced complications. Radical surgery was performed in a second operation in five patients because of involved margins and residual disease was found in two. At a median follow-up of three years, all 12 patients who received local excision and radiotherapy remained disease free, whereas a 50 percent recurrence rate was observed in patients who refused adjuvant radiotherapy. CONCLUSIONS: The results of this study support the feasibility of transanal endoscopic microsurgery for the treatment of selected patients with T2 rectal cancer. The addition of radiotherapy may decrease the rates of early local recurrence. However, at present, this treatment strategy should not be routinely considered for patients who may undergo radical procedures.
Authors:
Simon D Duek; Nidal Issa; Dan D Hershko; Michael M Krausz
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-01-31
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-20     Completed Date:  2008-05-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  379-84; discussion 384     Citation Subset:  IM    
Affiliation:
Unit of Colorectal Surgery, Rambam Medical Center, Haifa, Israel. d_duek@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy
Endoscopy, Gastrointestinal / methods*
Female
Follow-Up Studies
Humans
Male
Microsurgery / methods*
Middle Aged
Neoplasm Staging
Nose
Radiotherapy, Adjuvant / methods
Rectal Neoplasms / pathology,  radiotherapy*,  surgery*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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