Analysis of 116 cases of rectal cancer treated by transanal local excision

World Journal of Surgical Oncology

Gaofeng Liang¹  Jin Meng¹  Xiaoxia Li¹  Yuanxin Tang¹  Gongping Sun¹ 

[1] Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of the China Medical University, No. 4 Chongshan Road, Shenyang 110032, China

关键词: radiotherapy;    recurrence;    survival;    transanal local excision;    rectal cancer;   

Others  :  1148829
DOI  :  10.1186/1477-7819-12-202

 received in 2014-03-25, accepted in 2014-06-12,  发布年份 2014

【 摘 要 】

Background

The purpose of this research was to evaluate the therapeutic effects and prognostic factors of transanal local excision (TAE) for rectal cancer.

Methods

We retrospectively analyzed 116 cases that underwent TAE for rectal cancer from 1995 to 2008. A Cox regression analysis was used to analyze prognostic factors.

Results

The survival times for the patients were from 14 to 160.5 months (median time, 58.5 months). The 5-year and 10-year overall survival rates were 72% and 53%, respectively. In all 16 cases experienced local recurrence (13.8%). Pathological type, recurrence or metastasis, and depth of infiltration (T stage) were the prognostic factors according to the univariate analysis, and the latter two were independent factors affecting patient prognosis. For patients with T1 stage who underwent adjuvant radiotherapy, there was no local recurrence; for those in T2 stage, the local recurrence rate was 14.6%. In addition, there was no difference between the patients who received radiotherapy and those who did not (T1: P = 0.260, T2: P = 0.262 for survival rate and T1: P = 0.480, T2: P = 0.560 for recurrence).

Conclusions

The result of TAE for rectal cancer is satisfactory for T1 stage tumors, but it is not suitable for T2 stage tumors.

【 授权许可】

   
2014 Sun et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Yu D-S, Huang X-E, Zhou J-N: Comparative study on the value of anal preserving surgery for aged people with low rectal carcinoma in Jiangsu, China. Asian Pac J Cancer Prev 2012, 13:2339-2340.
• [2]Paun BC, Cassie S, MacLean AR, Dixon E, Buie WD: Postoperative complications following surgery for rectal cancer. Ann Surg 2010, 251:807-818.
• [3]Bao-ming Y: Progress in the diagnosis and treatment of lower rectal cancer. Chin J Practical Hand Surg 2002, 22:34-37.
• [4]Chang GJ, Rodriguez-Bigas MA, Skibber JM, Moyer VA: Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst 2007, 99:433-441.
• [5]Zhou X, Huang X-E, Zhang T, Shang J-Q, Guan X, Zhong J, Feng B, Sun Y, Zhou J-N: Extended full-thickness transanal local excision to treat ultra-low rectal cancer: an initial clinical exploration. Asian Pac J Cancer Prev 2011, 12:1045-1048.
• [6]Gao J-D, Shao Y-F, Bi J-J, Shi S-S, Liang J, Hu Y-H: Local excision carcinoma in early stage. World J Gastroenterol 2003, 9:871-873.
• [7]Nastro P, Beral D, Hartley J, Monson JR: Local excision of rectal cancer: review of literature. Dig Surg 2005, 22:6-15.
• [8]Sengupta S, Tjandra JJ: Local excision of rectal cancer. Dis Colon Rectum 2001, 44:1345-1361.
• [9]Garcia-Aguilar J, Mellgren A, Sirivongs P, Buie D, Madoff RD, Rothenberger DA: Local excision of rectal cancer without adjuvant therapy: a word of caution. Ann Surg 2000, 231:345.
• [10]Mellgren A, Sirivongs P, Rothenberger DA, Madoff RD, García-Aguilar J: Is local excision adequate therapy for early rectal cancer? Dis Colon Rectum 2000, 43:1064-1071.
• [11]Sharma A, Hartley J, Monson JR: Local excision of rectal tumours. Surg Oncol 2003, 12:51-61.
• [12]Compton CC: Colorectal carcinoma: diagnostic, prognostic, and molecular features. Mod Pathol 2003, 16:376-388.
• [13]Benson A 3rd, Choti M, Cohen A, Doroshow J, Fuchs C, Kiel K, Martin E Jr, McGinn C, Petrelli N, Posey J: NCCN practice guidelines for colorectal cancer. Oncology (Williston Park, NY) 2000, 14:203.
• [14]Graham RA, Hackford AW, Wazer DE: Local excision of rectal carcinoma: a safe alternative for more advanced tumors? J Surg Oncol 1999, 70:235-238.
• [15]Brown G, Davies S, Williams G, Bourne M, Newcombe R, Radcliffe A, Blethyn J, Dallimore N, Rees B, Phillips C: Effectiveness of preoperative staging in rectal cancer: digital rectal examination, endoluminal ultrasound or magnetic resonance imaging? Br J Cancer 2004, 91:23-29.
• [16]Hundt W, Braunschweig R, Reiser M: Evaluation of spiral CT in staging of colon and rectum carcinoma. Eur Radiol 1999, 9:78-84.
• [17]Veit-Haibach P, Kuehle CA, Beyer T, Stergar H, Kuehl H, Schmidt J, Börsch G, Dahmen G, Barkhausen J, Bockisch A: Diagnostic accuracy of colorectal cancer staging with whole-body PET/CT colonography. JAMA 2006, 296:2590-2600.
• [18]Weiser MR, Landmann RG, Wong WD, Shia J, Guillem JG, Temple LK, Minsky BD, Cohen AM, Paty PB: Surgical salvage of recurrent rectal cancer after transanal excision. Dis Colon Rectum 2005, 48:1169-1175.
• [19]Lee W, Lee D, Choi S, Chun H: Transanal endoscopic microsurgery and radical surgery for T1 and T2 rectal cancer. Surg Endosc 2003, 17:1283-1287.
• [20]Xin-shu D, Peng Z, Zhi-wei Y, Xi-shan W: Patterns and treatment of local recurrence after rectal carcinoma operation. Chin J Practical Hand Surg 2002, 22:334-336.
• [21]Greenberg JA, Shibata D, Herndon JE II, Steele GD Jr, Mayer R, Bleday R: Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum 2008, 51:1185-1194.
• [22]Chang AJBA, Nahas CSR, Araujo SEA, Nahas SC, Marques CFS, Kiss DR, Cecconello I: Early rectal cancer: local excision or radical surgery? J Surg Educ 2008, 65:67-72.
• [23]Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF: Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004, 351:1731-1740.
• [24]Valentini V, Aristei C, Glimelius B, Minsky BD, Beets-Tan R, Borras JM, Haustermans K, Maingon P, Overgaard J, Pahlman L: Multidisciplinary rectal cancer management: 2nd European rectal cancer consensus conference (EURECA-CC2). Radiother Oncol 2009, 92:148-163.
• [25]Borschitz T, Wachtlin D, Möhler M, Schmidberger H, Junginger T: Neoadjuvant chemoradiation and local excision for T2-3 rectal cancer. Ann Surg Oncol 2008, 15:712-720.
• [26]Kim CJ, Yeatman TJ, Coppola D, Trotti A, Williams B, Barthel JS, Dinwoodie W, Karl RC, Marcet J: Local excision of T2 and T3 rectal cancers after downstaging chemoradiation. Ann Surg 2001, 234:352.
• [27]Taylor RH, Hay JH, Larsson SN: Transanal local excision of selected low rectal cancers. Am J Surg 1998, 175:360-363.
• [28]Visser BC, Varma MG, Welton ML: Local therapy for rectal cancer. Surg Oncol 2001, 10:61-69.