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James Church, MBChB, FRACS

Arch Surg. 2007;142(7):656.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

It is a truism that, in the treatment of rectal cancer, the best chance for cure is the first chance. Therefore, the principle is established that the first priority of rectal cancer treatment is complete eradication of the disease. This philosophy somewhat defuses the debate over local vs radical resection because, as the authors point out, local excision is a compromise. In this compromise, nodal excision and wide margins are sacrificed in favor of reducing morbidity and, perhaps, preserving anal defecation. Whether this compromise is reasonable depends on the risk of nodal involvement with cancer, the likelihood of obtaining clear margins with local excision, and the comorbidity of the patient. Recent reports of oncologic outcome of local excision for T1 cancers suggest that the risk of local recurrence can be surprisingly high.^1-3

Considering local excision as an option for the treatment of rectal cancer assumes, of . . . [Full Text of this Article]

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