Outcomes for early rectal cancer managed with transanal endoscopic microsurgery: a 5-year follow-up study

Surg Endosc. 2006 Apr;20(4):541-5. doi: 10.1007/s00464-005-0408-y. Epub 2006 Feb 27.


Background: This study aimed to evaluate the long-term risk of local and distant recurrence as well as the survival of patients with early rectal cancer treated using transanal endoscopic microsurgery (TEM).

Methods: The study reviewed 69 patients with Tis/T1/T2 rectal cancer treated using full-thickness excision between 1991 and 1999. The pathology T-stages included 25 Tis, 23 T1, and 21 T2. The median follow-up period was 6.5 years (range 5-10.2 years).

Results: The overall local recurrence rate was 8.7%. The 5-year local recurrence rate was 8% for Tis, 8.6% for T1, and 9.5% for T2. All six patients with recurrence were managed surgically. The 5-year disease-specific survival rate was 100% for Tis, 100% for T1, and 70% for T2. The overall cancer-related mortality rate was 7.2%.

Conclusions: After local excision of early rectal cancer, a substantial local recurrence rate is observed. Patients with recurrent Tis/T1 cancers who undergo a salvage operation may achieve good long-term outcome. Local treatment without adjuvant therapy for T2 rectal cancers appears inadequate.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal
  • Chemotherapy, Adjuvant
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microsurgery* / adverse effects
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Postoperative Care
  • Preoperative Care
  • Proctoscopy / adverse effects
  • Proctoscopy / methods*
  • Radiotherapy, Adjuvant
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Reoperation
  • Survival Analysis
  • Treatment Outcome