The results of 21 patients with localized, resectable low rectal cancer treated with transanal excision and postoperative radiation therapy are reported. All had negative resection margins except one patient who underwent a salvage adbominoperineal resection; however no residual tumour could be found in the specimen. After a mean follow-up of 33 months (range 29-61), 17 patients (85%) are alive with no sign of local or distant failure. Another disease-free patient died of acute mesenteric infarction 8 months after surgery. Two patients (9.5%) developed a local failure and were both salvaged with major resection. Postoperative and radiotherapy-related morbidity was minimal. Slight proctitis with diarrhoea and perianal discomfort occurred in all patients following irradiation. Long-term anal sphincter function was satisfactory in 90% of cases. Endorectal ultrasonography provided reliable preoperative staging of both T and N parameters, appearing as the key investigation in selecting candidates for conservative treatment. Postoperative radiotherapy offered good local control of the disease and might be proposed also after excision of T1 cancers, since it produced few side effects. Additional experience is needed to determine whether this combined radiosurgical approach will eventually become the treatment of choice for highly selected low rectal cancers.
|Translated title of the contribution||Conservative treatment of low rectal cancer. The role of radiotherapy|
|Number of pages||5|
|Publication status||Published - 1995|
ASJC Scopus subject areas