LOCAL EXCISION AND EXTERNAL-BEAM RADIOTHERAPY IN EARLY RECTAL-CANCER

Purpose: To assess the local control and survival of local excision an d postoperative radiation in patients with early stage rectal cancer. Methods and Materials: From 1980 to 1992, 21 patients with clinical st age T1-2NxM0 adenocarcinoma of the middle and lower rectum were treate d with transanal excision and postoperative external beam radiotherapy (44.6 Gy), The pathologic T stages were: 9 T1 (43%) and 12 T2 (57%), One patient had unassessable resection margins, The median follow-up w as 54 months (range: 18-128 months), Results: The actuarial local recu rrence-free survival at 5 years was 85.2%, and the overall survival at 5 years was 80.6%. One patient developed a local recurrence and dista nt metastases at 22 months, and two patients had local recurrence at 1 1 and 15 months, respectively; both had abdomino-perineal resection (A PR) and one remained free of disease 16 months after APR, The incidenc e of Grade 3 diarrhea was 5%, Sphincter function was good to excellent in the 18 patients with local control, No patients developed clinical evidence of pelvic lymph node recurrence, Conclusion: These results a re similar to other published series and suggest that this approach is feasible in selected patients with T1-2NxM0 rectal cancer and results in good long-term control of the disease.