Selection factors for local excision or abdominoperineal resection of early stage rectal cancer

作者：Christopher G. Willett, Carolyn C. Compton, Paul C. Shellito, Jimmy T. Efird · 发表于：Cancer · 年份：1994 · DOI：10.1002/1097-0142(19940601)73:11<2716::aid-cncr2820731111>3.0.co;2-9 · 被引用次数：165 · 研究领域：Colorectal Cancer Surgical Treatments、Colorectal and Anal Carcinomas、Esophageal Cancer Research and Treatment

BACKGROUND: This study reviews the experience of patients with early stage rectal cancer managed by local excision or abdominoperineal resection to clarify the relative indications and results of these two approaches. METHODS: From 1962 to 1991, 125 patients with T1 and T2 rectal cancer underwent local excision (56 patients) or abdominoperineal resection (69 patients). Outcome was analyzed by stage, treatment, and pathologic features of tumor grade and vessel involvement. RESULTS: The 5-year actuarial recurrence-free survival and local control was 87% and 96%, respectively, for 28 patients undergoing local excision with favorable histologic features (well or moderately well differentiated histologic findings without venous/lymph vessel involvement). These results were 57% and 68% for 28 patients with unfavorable histologic features (poorly differentiated histology and/or venous/lymph vessel involvement). For patients undergoing abdominoperineal resection, the 5-year actuarial recurrence-free survival and local control of 49 patients with favorable histologic features was 91% and 91%, respectively. These results were 79% and 89%, respectively, for patients with poorly differentiated histology or venous/lymph vessel involvement. CONCLUSIONS: For patients with T1 and T2 tumors having favorable histologic features, a satisfactory survival and local control was achieved for patients undergoing local excision or abdominoperineal resection. In contrast, patients with T1 and T2 tumor...