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Local Excision of Rectal Carcinoma
Madhulika G. Varma, MD;
Stanley J. Rogers, MD;
Theodore R. Schrock, MD;
Mark L. Welton, MD
Arch Surg. 1999;134:863-868.
Hypothesis Selected clinicopathologic characteristics of locally treated rectal cancers are predictive of recurrence.
Design Case series review with median follow-up of 6 years.
Setting University medical center.
Patients Fifty-eight patients with rectal cancer who underwent local excisions from February 1, 1982, to December 31, 1998.
Main Outcome Measures Local and distant recurrence rates and overall survival.
Results Overall local recurrence rate was 14% (8 patients). There were no local recurrences among patients treated with chemotherapy or radiation. Of patients not treated, local recurrence rates were 33%, 5%, 45%, and 25% for T0, T1, T2, and T3 tumors, respectively. No clinicopathologic factor predicted local recurrence. Two patients developed distant recurrence. Overall survival was 98%, 93%, and 84% at 1, 3, and 5 years, respectively.
Conclusion In selected patients, outcomes for local excision combined with additional therapy may be equivalent to those for radical resection.
From the Department of Surgery, University of California, San Francisco.
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