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Transanal endoscopic microsurgery for rectal cancer. Long-term oncologic results

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Local excision of malignant rectal tumors remains controversial due to the lack of prospective studies. The principal aim of this paper is to analyze survival and recurrence of patients with rectal cancer who were operated by transanal endoscopic microsurgery with curative intention.

Methods

In 1997, we started a prospective protocol for patients who had T1/T2 rectal tumors: transanal local full-thickness excision was considered curative in T1 low risk (group A); patients with T1 high-risk and T2 low-risk tumors received postoperative radiotherapy (group B). From 1997 to 2006, 88 patients were enrolled. Sixty eight entered the study after the preoperative workup and 20 patients with an initial diagnosis of adenoma after postoperative definitive pathological assessment.

Results

After definitive histological findings, 54 patients were to group A, 28 to group B, and 6 had immediate radical surgery. One patient was lost for follow-up. At a mean follow-up of 71 months, 7 (4 from group A and 3 from group B) out of 81 patients recurred. Five-year overall survival was of 94% and cancer-specific survival of 96%.

Conclusions

Our data support that transanal endoscopic microsurgery is an adequate treatment for T1 low-risk tumor, and no additional measures are required. For T2 low-risk lesions, our study showed a higher local recurrence rate than that reported after radical surgery but a similar survival outcome.

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Acknowledgments

This study was supported by Spanish “Fondo de Investigacion Sanitaria, Ministerio de Sanidad y Consumo” grants 98/9788 and 01/0186.

Conflict of interest

The authors declare that they have not conflict of interest.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, University Hospital, Zaragoza, Spain

    Jose M. Ramirez, Vicente Aguilella, Jose A. Gracia & Mariano Martinez

  2. Department of Radiotherapy, University Hospital, Zaragoza, Spain

    Javier Valencia & Ricardo Esco

  3. Department of Pathology, University Hospital, Zaragoza, Spain

    Javier Ortego

  4. Department of Oncology, University Hospital, Zaragoza, Spain

    Pilar Escudero

  5. Department Colorectal Surgery, Hospital Clínico Universitario, San Juan Bosco 15, Zaragoza, 50009, Spain

    Jose M. Ramirez

Authors
  1. Jose M. Ramirez
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  2. Vicente Aguilella
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  3. Javier Valencia
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  4. Javier Ortego
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  5. Jose A. Gracia
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  6. Pilar Escudero
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  7. Ricardo Esco
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  8. Mariano Martinez
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Corresponding author

Correspondence to Jose M. Ramirez.

Additional information

Supported by Spanish “Fondo de Investigación Sanitaria. Ministerio de Sanidad y Consumo” grants 98/0788 and 01/0186.

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Ramirez, J.M., Aguilella, V., Valencia, J. et al. Transanal endoscopic microsurgery for rectal cancer. Long-term oncologic results. Int J Colorectal Dis 26, 437–443 (2011). https://doi.org/10.1007/s00384-011-1132-9

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  • DOI: https://doi.org/10.1007/s00384-011-1132-9

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