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Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection

PURPOSE: Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer. METHODS: T1 rec...

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Autores principales: Hwang, Yunghuyn, Yoon, Yong Sik, Bong, Jun Woo, Choi, Hye Yun, Song, In Ho, Lee, Jong Lyul, Kim, Chan Wook, Park, In Ja, Lim, Seok-Byung, Yu, Chang Sik, Kim, Jin Cheon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Coloproctology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732326/
https://www.ncbi.nlm.nih.gov/pubmed/31487767
http://dx.doi.org/10.3393/ac.2018.10.18.2
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author Hwang, Yunghuyn
Yoon, Yong Sik
Bong, Jun Woo
Choi, Hye Yun
Song, In Ho
Lee, Jong Lyul
Kim, Chan Wook
Park, In Ja
Lim, Seok-Byung
Yu, Chang Sik
Kim, Jin Cheon
author_facet Hwang, Yunghuyn
Yoon, Yong Sik
Bong, Jun Woo
Choi, Hye Yun
Song, In Ho
Lee, Jong Lyul
Kim, Chan Wook
Park, In Ja
Lim, Seok-Byung
Yu, Chang Sik
Kim, Jin Cheon
author_sort Hwang, Yunghuyn
collection PubMed
description PURPOSE: Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer. METHODS: T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery. RESULTS: Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR. CONCLUSION: Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients.
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spelling pubmed-67323262019-09-12 Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection Hwang, Yunghuyn Yoon, Yong Sik Bong, Jun Woo Choi, Hye Yun Song, In Ho Lee, Jong Lyul Kim, Chan Wook Park, In Ja Lim, Seok-Byung Yu, Chang Sik Kim, Jin Cheon Ann Coloproctol Original Article PURPOSE: Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer. METHODS: T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery. RESULTS: Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR. CONCLUSION: Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients. Korean Society of Coloproctology 2019-08 2019-08-31 /pmc/articles/PMC6732326/ /pubmed/31487767 http://dx.doi.org/10.3393/ac.2018.10.18.2 Text en Copyright © 2019 The Korean Society of Coloproctology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hwang, Yunghuyn
Yoon, Yong Sik
Bong, Jun Woo
Choi, Hye Yun
Song, In Ho
Lee, Jong Lyul
Kim, Chan Wook
Park, In Ja
Lim, Seok-Byung
Yu, Chang Sik
Kim, Jin Cheon
Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title_full Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title_fullStr Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title_full_unstemmed Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title_short Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
title_sort long-term transanal excision outcomes in patients with t1 rectal cancer: comparative analysis of radical resection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732326/
https://www.ncbi.nlm.nih.gov/pubmed/31487767
http://dx.doi.org/10.3393/ac.2018.10.18.2
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