Sphincter preservation in rectal cancer by local excision and postoperative radiation therapy Journal Article


Authors: Minsky, B. D.; Cohen, A. M.; Enker, W. E.; Mies, C.
Article Title: Sphincter preservation in rectal cancer by local excision and postoperative radiation therapy
Abstract: Authors report the preliminary results of 14 patients with localized, mobile, resectable rectal cancer treated with local excision and postoperative radiation therapy (RT). All had negative surgical resection margins and two received 5‐fluorouracil (5‐FU). The median follow‐up was 29 months (4—43 months). The 3‐year actuarial survival was 88%. The incidence of local failure was 7% (only site of failure) and 21% (component of failure). The incidence of local failure increased with T stage (T1, 0/3 [0%]; T2, 1/7 [14%]; and T3, 2/4 [50%]) and tumor size (> 3 cm, 33%, versus ± 3 cm, 0%). Three patients developed local failure at 6, 15, and 21 months. Three underwent a salvage abdominoperineal resection and were locally controlled at 2 and 28 months following salvage surgery. One patient underwent an abdominoperineal resection for a clinically presumed local failure; however, no tumor was found in the specimen. Therefore, the 13 patients who either were initially locally controlled or underwent salvage or nonsalvage surgery had no evidence of disease in the pelvis at the time of last follow‐up. Local excision and postoperative RT may be an alternative to standard surgery in selected cases. However, additional follow‐up and more experience are needed in order to determine if this approach will ultimately have local control and survival rates similar to those of a low anterior resection or an abdominoperineal resection. Copyright © 1991 American Cancer Society
Keywords: adult; clinical article; aged; survival rate; fluorouracil; combined modality therapy; follow-up studies; neoplasm staging; adenocarcinoma; radiotherapy dosage; reoperation; brachytherapy; rectal neoplasms; rectum cancer; sphincter; middle age; anus; human; male; female; priority journal; article; support, non-u.s. gov't
Journal Title: Cancer
Volume: 67
Issue: 4
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1991-02-15
Start Page: 908
End Page: 914
Language: English
DOI: 10.1002/1097-0142(19910215)67:4<908::Aid-cncr2820670409>3.0.Co;2-b
PUBMED: 1991263
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 27 September 2019 -- Source: Scopus
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MSK Authors
  1. Bruce Minsky
    306 Minsky
  2. Alfred M Cohen
    244 Cohen
  3. Warren E. Enker
    70 Enker
  4. Carolyn Mies
    13 Mies