Conservative management of rectal cancer with local excision and postoperative adjuvant therapy Journal Article
| Authors: | Wagman, R.; Minsky, B. D.; Cohen, A. M.; Saltz, L.; Paty, P. B.; Guillem, J. G. |
| Article Title: | Conservative management of rectal cancer with local excision and postoperative adjuvant therapy |
| Abstract: | Background: To determine the local control, survival, and functional outcome of local excision plus postoperative therapy for patients with rectal cancer. Methods: A total of 39 patients underwent a local excision (2 with snare excision of a T1 polyp and 37 with full-thickness local excision) followed by postoperative radiation therapy ± 5-FU-based chemotherapy. The median follow-up was 41 months, and 11 patients had positive margins. Results: The 5-year actuarial colostomy-free survival was 87% and overall survival was 70%. Crude local failure increased with T stage: 0% T1, 24% T2, and 25% T3. Of the 8 patients (21%) who developed local failure, 5 underwent salvage APR and were locally controlled. Actuarial local failure at 5 years was 31% for T2 disease and 27% for the total patient group. In the 32 patients with an intact sphincter, 94% had good to excellent sphincter function. Conclusion: Although local failure in patients with T2 tumors has increased since our prior report, the survival, sphincter function, and local salvage rates are acceptable. Local excision and postoperative therapy remains a reasonable alternative to APR in selected patients. |
| Keywords: | adult; cancer chemotherapy; cancer survival; clinical article; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; treatment failure; fluorouracil; cancer radiotherapy; postoperative care; radiotherapy, adjuvant; cancer staging; adenocarcinoma; conservative treatment; rectal neoplasms; rectum cancer; rectal cancer; anal canal; sphincter preservation; local excision; humans; human; male; female; priority journal; article |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 44 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1999-07-01 |
| Start Page: | 841 |
| End Page: | 846 |
| Language: | English |
| DOI: | 10.1016/s0360-3016(99)00094-2 |
| PUBMED: | 10386641 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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