Ventsislav Mutafchiyski1, Georgi Popivanov1, Emilia Naseva2, Kyosev Vasil1, Kirien Kjossev3, Plamen Ivanov1, Grigor Grigorov1, Georgi Kotashev1, Krasimir Vasilev1, Marin Penkov4
1) Clinic of Endoscopic, Endocrine surgery and Coloproctology, Military Medical Academy, Sofia.,
2) Faculty of Public Health, Medical University – Sofia.,
3) Clinic of Abdominal Surgery, Military Medical Academy, Sofia.,
4) Clinic of Radiology, UHAT “St. John Rilski”, Sofia
Disclosure: The author has declared no conflicts of interest.
Received: 19.02.16 Accepted: 26.02.16
Currently, there has been an increasing trend toward transanal endoscopic microsurgery as a definitive treatment of T1 rectal cancer. Despite the promising results from the earlier series, the more recent studies reported a higher rate of local recurrences.
A retrospective analysis of 20 patients with T1 rectal cancer managed by transanal endoscopic microsurgery is presented.
The patients were followed-up for mean 39.3 months. Local recurrences occurred in 5.3% of low-risk, 50% of high-risk T1 cases. The 3-year and 5-year cancer-specific survival in T1 group were 94.4% and 73.5%, respectively with mean time without LR was 81.5 months (90.5 months in the low-risk and 21 months in the high-risk group).
The results corroborate the excellent prognosis for low-risk T1 cancers treated by TEM alone. For a high-risk T1 cancer adjuvant radiotherapy or conventional resection is highly recommended.
Keywords: early rectal cancer, transanal endoscopic microsurgery, risk factors, adjuvant radiotherapy
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