Local excision for early rectal cancer - is it proper surgical decision?

Abstract

Sphincter preservation, disease control, and long-term survival are the main goals in the treatment of rectal cancer. Although transanal local excision is attractive because it is a sphincter spar ing procedure, some contradictory data exist in the literature about its ability to locally control disease and provide over all survival comparable with radical procedures, even for patients with early stage tumor. In patients with early rectal cancer (T1), local excision may be an alternative approach in highly selected patients. For more advanced rectal cancer, radical surgical resection is the treatment of choice. METHODS: We reviewed the literature to identify the current recurrence and survival rates of both techniques as well as the salvage surgery success, only 1 study was prospective, 5 were comparative, and 5 were case reports. We present a case report of a woman with local excision of rectal tumor. Five years later a rectal recurrence has showed up. We describe the case and make some conclusions. Scripta Scientifica Medica 2009; 41(2): 169-171.