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 recta...
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Autor*in:	Yunghuyn Hwang [verfasserIn] Yong Sik Yoon [verfasserIn] Jun Woo Bong [verfasserIn] Hye Yun Choi [verfasserIn] In Ho Song [verfasserIn] Jong Lyul Lee [verfasserIn] Chan Wook Kim [verfasserIn] In Ja Park [verfasserIn] Seok-Byung Lim [verfasserIn] Chang Sik Yu [verfasserIn] Jin Cheon Kim [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	rectal neoplasms colorectal surgery survival

Übergeordnetes Werk:	In: Annals of Coloproctology - Korean Society of Coloproctology, 2022, 35(2019), 4, Seite 194-201
Übergeordnetes Werk:	volume:35 ; year:2019 ; number:4 ; pages:194-201

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.3393/ac.2018.10.18.2

Katalog-ID:	DOAJ013450360

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520			\|a 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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allfields	10.3393/ac.2018.10.18.2 doi (DE-627)DOAJ013450360 (DE-599)DOAJae2baba99579486680c33c7cdec750d5 DE-627 ger DE-627 rakwb eng RC799-869 Yunghuyn Hwang verfasserin aut Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. rectal neoplasms colorectal surgery survival Diseases of the digestive system. Gastroenterology Yong Sik Yoon verfasserin aut Jun Woo Bong verfasserin aut Hye Yun Choi verfasserin aut In Ho Song verfasserin aut Jong Lyul Lee verfasserin aut Chan Wook Kim verfasserin aut In Ja Park verfasserin aut Seok-Byung Lim verfasserin aut Chang Sik Yu verfasserin aut Jin Cheon Kim verfasserin aut In Annals of Coloproctology Korean Society of Coloproctology, 2022 35(2019), 4, Seite 194-201 (DE-627)742225496 (DE-600)2711906-3 22879722 nnns volume:35 year:2019 number:4 pages:194-201 https://doi.org/10.3393/ac.2018.10.18.2 kostenfrei https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 kostenfrei http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf kostenfrei https://doaj.org/toc/2287-9714 Journal toc kostenfrei https://doaj.org/toc/2287-9722 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 35 2019 4 194-201
spelling	10.3393/ac.2018.10.18.2 doi (DE-627)DOAJ013450360 (DE-599)DOAJae2baba99579486680c33c7cdec750d5 DE-627 ger DE-627 rakwb eng RC799-869 Yunghuyn Hwang verfasserin aut Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. rectal neoplasms colorectal surgery survival Diseases of the digestive system. Gastroenterology Yong Sik Yoon verfasserin aut Jun Woo Bong verfasserin aut Hye Yun Choi verfasserin aut In Ho Song verfasserin aut Jong Lyul Lee verfasserin aut Chan Wook Kim verfasserin aut In Ja Park verfasserin aut Seok-Byung Lim verfasserin aut Chang Sik Yu verfasserin aut Jin Cheon Kim verfasserin aut In Annals of Coloproctology Korean Society of Coloproctology, 2022 35(2019), 4, Seite 194-201 (DE-627)742225496 (DE-600)2711906-3 22879722 nnns volume:35 year:2019 number:4 pages:194-201 https://doi.org/10.3393/ac.2018.10.18.2 kostenfrei https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 kostenfrei http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf kostenfrei https://doaj.org/toc/2287-9714 Journal toc kostenfrei https://doaj.org/toc/2287-9722 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 35 2019 4 194-201
allfields_unstemmed	10.3393/ac.2018.10.18.2 doi (DE-627)DOAJ013450360 (DE-599)DOAJae2baba99579486680c33c7cdec750d5 DE-627 ger DE-627 rakwb eng RC799-869 Yunghuyn Hwang verfasserin aut Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. rectal neoplasms colorectal surgery survival Diseases of the digestive system. Gastroenterology Yong Sik Yoon verfasserin aut Jun Woo Bong verfasserin aut Hye Yun Choi verfasserin aut In Ho Song verfasserin aut Jong Lyul Lee verfasserin aut Chan Wook Kim verfasserin aut In Ja Park verfasserin aut Seok-Byung Lim verfasserin aut Chang Sik Yu verfasserin aut Jin Cheon Kim verfasserin aut In Annals of Coloproctology Korean Society of Coloproctology, 2022 35(2019), 4, Seite 194-201 (DE-627)742225496 (DE-600)2711906-3 22879722 nnns volume:35 year:2019 number:4 pages:194-201 https://doi.org/10.3393/ac.2018.10.18.2 kostenfrei https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 kostenfrei http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf kostenfrei https://doaj.org/toc/2287-9714 Journal toc kostenfrei https://doaj.org/toc/2287-9722 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 35 2019 4 194-201
allfieldsGer	10.3393/ac.2018.10.18.2 doi (DE-627)DOAJ013450360 (DE-599)DOAJae2baba99579486680c33c7cdec750d5 DE-627 ger DE-627 rakwb eng RC799-869 Yunghuyn Hwang verfasserin aut Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. rectal neoplasms colorectal surgery survival Diseases of the digestive system. Gastroenterology Yong Sik Yoon verfasserin aut Jun Woo Bong verfasserin aut Hye Yun Choi verfasserin aut In Ho Song verfasserin aut Jong Lyul Lee verfasserin aut Chan Wook Kim verfasserin aut In Ja Park verfasserin aut Seok-Byung Lim verfasserin aut Chang Sik Yu verfasserin aut Jin Cheon Kim verfasserin aut In Annals of Coloproctology Korean Society of Coloproctology, 2022 35(2019), 4, Seite 194-201 (DE-627)742225496 (DE-600)2711906-3 22879722 nnns volume:35 year:2019 number:4 pages:194-201 https://doi.org/10.3393/ac.2018.10.18.2 kostenfrei https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 kostenfrei http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf kostenfrei https://doaj.org/toc/2287-9714 Journal toc kostenfrei https://doaj.org/toc/2287-9722 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 35 2019 4 194-201
allfieldsSound	10.3393/ac.2018.10.18.2 doi (DE-627)DOAJ013450360 (DE-599)DOAJae2baba99579486680c33c7cdec750d5 DE-627 ger DE-627 rakwb eng RC799-869 Yunghuyn Hwang verfasserin aut Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. rectal neoplasms colorectal surgery survival Diseases of the digestive system. Gastroenterology Yong Sik Yoon verfasserin aut Jun Woo Bong verfasserin aut Hye Yun Choi verfasserin aut In Ho Song verfasserin aut Jong Lyul Lee verfasserin aut Chan Wook Kim verfasserin aut In Ja Park verfasserin aut Seok-Byung Lim verfasserin aut Chang Sik Yu verfasserin aut Jin Cheon Kim verfasserin aut In Annals of Coloproctology Korean Society of Coloproctology, 2022 35(2019), 4, Seite 194-201 (DE-627)742225496 (DE-600)2711906-3 22879722 nnns volume:35 year:2019 number:4 pages:194-201 https://doi.org/10.3393/ac.2018.10.18.2 kostenfrei https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 kostenfrei http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf kostenfrei https://doaj.org/toc/2287-9714 Journal toc kostenfrei https://doaj.org/toc/2287-9722 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 35 2019 4 194-201
language	English
source	In Annals of Coloproctology 35(2019), 4, Seite 194-201 volume:35 year:2019 number:4 pages:194-201
sourceStr	In Annals of Coloproctology 35(2019), 4, Seite 194-201 volume:35 year:2019 number:4 pages:194-201
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authorswithroles_txt_mv	Yunghuyn Hwang @@aut@@ Yong Sik Yoon @@aut@@ Jun Woo Bong @@aut@@ Hye Yun Choi @@aut@@ In Ho Song @@aut@@ Jong Lyul Lee @@aut@@ Chan Wook Kim @@aut@@ In Ja Park @@aut@@ Seok-Byung Lim @@aut@@ Chang Sik Yu @@aut@@ Jin Cheon Kim @@aut@@
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author	Yunghuyn Hwang
spellingShingle	Yunghuyn Hwang misc RC799-869 misc rectal neoplasms misc colorectal surgery misc survival misc Diseases of the digestive system. Gastroenterology Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
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topic_title	RC799-869 Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection rectal neoplasms colorectal surgery survival
topic	misc RC799-869 misc rectal neoplasms misc colorectal surgery misc survival misc Diseases of the digestive system. Gastroenterology
topic_unstemmed	misc RC799-869 misc rectal neoplasms misc colorectal surgery misc survival misc Diseases of the digestive system. Gastroenterology
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title	Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
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title_sort	long-term transanal excision outcomes in patients with t1 rectal cancer: comparative analysis of radical resection
callnumber	RC799-869
title_auth	Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
abstract	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.
abstractGer	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.
abstract_unstemmed	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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title_short	Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
url	https://doi.org/10.3393/ac.2018.10.18.2 https://doaj.org/article/ae2baba99579486680c33c7cdec750d5 http://coloproctol.org/upload/pdf/ac-2018-10-18-2.pdf https://doaj.org/toc/2287-9714 https://doaj.org/toc/2287-9722
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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.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">rectal neoplasms</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">colorectal surgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">survival</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the digestive system. 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Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection

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