LOCAL TREATMENT OF SMALL CANCERS OF THE RECTUM - EXCISION IS PREFERABLE TO ELECTROCOAGULATION

From 1973 to 1990, 50 patients with a ''small cancer'' of the rectum w ere treated locally either by electrocoagulation or by local excision using an electrical scalpel. 20 patients were treated by electrocoagul ation. Their 5-year actuarial survival was 78.3 % and the local recurr ence rate was 16.5 %. 4 treated patients by local excision had a lesio n which invaded the serosa and should have been amputated as primary p rocedure. Three of them relapsed. 26 patients were treated by local ex cision for a lesion confined to the rectal wall. Their 5-year actuaria l survival was 94.4 % and the local recurrence rate was 4.5 %. The dif ference in survival and recurrence was significant between electrocoag ulation and excision of a lesion confined to the rectal wall. These re sults suggest that excision is preferable to electrocoagulation as it allows prediction of the result by pathological examination of the ope rative specimen.