[Local excision and adjuvant radiotherapy for rectal adenocarcinoma T1-2 N0]

Gastroenterol Clin Biol. 2000 Apr;24(4):430-5.
[Article in French]

Abstract

Aim: To study retrospectively the relapse rate, the functional results and the survival rate in patients with rectal carcinoma treated with local excision and adjuvant radiotherapy.

Methods: Between 1980 and 1995, 43 patients were treated. All cancers were infiltrating tumours except 4 high grade dysplasias with positive margins. The pT classification was: pT1 (n=34), pT2 (n=4), pT3 (n=1). In 4 cases the depth of penetration of the tumor into the bowel wall was not evaluable. The endo-anal excision was performed by surgery (n=20) or by endoscopy (n=23). Only the tumor bed was irradiated in 35 cases (contact x-ray therapy: 30, interstitial iridium implant: 5) and in 8 cases the whole rectum was irradiated with external beam radiotherapy (+/- endocavitary irradiation).

Results: Median follow-up was 72 months. Four malignant relapses were observed (local: 1, perirectal lymphatic: 2, distant metastasis: 1). The overall 5- and 10-year survival rates were 80 and 68%, respectively. A total of 41 patients preserved a normal sphincter (95%). The anal function was evaluated as excellent or good in all the cases. No severe radiation toxicity was observed.

Conclusion: Small rectal carcinomas T1 N0 can be effectively treated in most cases by local excision and postoperative radiation therapy. A close multidisciplinary collaboration is necessary to achieve an optimal result.

Publication types

  • English Abstract

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / radiotherapy*
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / radiotherapy*
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Survival Rate