Are we doing too much?: local excision before radical surgery in early rectal cancer

2018 ◽  
Vol 33 (4) ◽  
pp. 383-391
Author(s):  
Sun Min Park ◽  
Bong-Hyeon Kye ◽  
Min Ki Kim ◽  
Heba E. Jalloun ◽  
Hyeon-Min Cho ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Early Rectal Cancer

Early Rectal Cancer: Local Excision or Radical Surgery?

2008 ◽  
Vol 65 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Alexandre Jin Bok Audi Chang ◽  
Caio Sergio Rizkallah Nahas ◽  
Sergio E. Alonso Araujo ◽  
Sergio C. Nahas ◽  
Carlos F. Sparapan Marques ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Early Rectal Cancer

Salvage Radical Surgery After Failed Local Excision for Early Rectal Cancer

2002 ◽  
Vol 45 (7) ◽  
pp. 875-879 ◽  
Author(s):  
Charles M. Friel ◽  
John W. Cromwell ◽  
Claudio Marra ◽  
Robert D. Madoff ◽  
David A. Rothenberger ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Early Rectal Cancer

scholarly journals A multi-centred randomised trial of radical surgery versus adjuvant chemoradiotherapy after local excision for early rectal cancer

BMC Cancer ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
W. A. A. Borstlap ◽  
P. J. Tanis ◽  
T. W. A. Koedam ◽  
C. A. M. Marijnen ◽  
C. Cunningham ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Randomised Trial ◽  
Adjuvant Chemoradiotherapy ◽  
Early Rectal Cancer

Influence of Histomorphological Parameters and Ploidy on Recurrence-Free Survival Time in Early Rectal Cancer after Local Excision

1993 ◽  
Vol 10 (6) ◽  
pp. 300-305
Author(s):  
T. Böttger ◽  
A. Heinz ◽  
D. Potratz ◽  
M. Stöckle ◽  
T. Junginger
Keyword(s):  
Rectal Cancer ◽  
Survival Time ◽  
Local Excision ◽  
Recurrence Free Survival ◽  
Early Rectal Cancer ◽  
Free Survival

Residual rectal cancer after preoperative radiochemotherapy (ypT1-2): An indication for local excision instead of radical surgery?

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 546-546
Author(s):  
Thilo Sprenger ◽  
Hilka Rothe ◽  
Lena-Christin Conradi ◽  
Kia Homayounfar ◽  
Tim Beissbarth ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Bowel Wall ◽  
Radical Surgery ◽  
Pathologic Complete Response ◽  
Residual Tumor ◽  
Complete Response ◽  
Phase Iii ◽  
Preoperative Radiochemotherapy ◽  
Cancer Trial

546 Background: Preoperative radiochemotherapy (RCT) followed by total mesorectal excision (TME) has improved local tumor control and led to a significant tumor downstaging. For patients with pathologic complete response (ypT0) as well as residual tumor restricted only to the bowel wall (ypT1-2) local excision has increasingly been discussed to avoid significant morbidity and functional deficits associated with TME. Therefore we investigated the incidence, distribution and tumor-related localization of mesorectal lymph node (LN) metastases in TME specimens with ypT0, ypT1-2 and ypT3-4 rectal cancers, respectively. Methods: TME specimens from 81 patients with locally advanced rectal cancer treated with neoadjuvant RCT within the phase III German Rectal Cancer Trial CAO/ARO/AIO-04 were evaluated. The entire mesorectal compartment was screened microscopically after complete paraffin embedding. The number and localization of all detectable LN metastases was specified in relation to the primary tumor. Results: Whereas 50 patients (62%) had ypT3-4 carcinomas after neoadjuvant RCT 20 patients (25%) presented with residual tumor within the bowel wall (ypT1-2). 11 patients (14%) had pathologic complete response (ypT0). 28 ± 13.7 LN were detected per specimen. 25 patients (31%) had residual LN metastases after RCT. Although the incidence was higher in the ypT3-4 group (40% ypN+) still 25% of patients in the ypT1-2 group had a mean number of 2.2 residual LN metastases. 55% of these metastases were located afar from the primary lesion in the proximal mesorectum. No patient with ypT0 status had residual LN metastases. Conclusions: Even in patients with good response and tumors restricted only to the bowel wall (ypT1-2) after RCT there is a considerable risk for residual LN metastases. The majority of metastases were located clearly outside the tumor region. Local excision of residual rectal cancer would be accompanied by a higher rate of local failure and radical surgery with TME should remain the standard treatment in those patients.

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