A RETROSPECTIVE COMPARISON OF TRANSANAL SURGERY AND ENDOCAVITARY RADIATION FOR THE TREATMENT OF EARLY RECTAL ADENOCARCINOMA

Objective: To compare two techniques for the local treatment of ''earl y'' rectal adenocarcinoma. Design and Study Participants: A retrospect ive comparison of 27 patients who underwent transanal disk excision an d fulguration (group A) and 38 patients who underwent transanal endoca vitary radiation (group B). Settings: inpatient and outpatient. Interv ention: Group A patients had rectal adenocarcinoma treated with disk e xcision and fulguration. Group B patients received 100 to 125 Gy in fo ur to five fractions using the Phillips RT-50 unit. Main Outcomes Meas ures: Survival and local recurrence. Results: The median follow-up for group A was 68 months; for group B, 38 months. The mean tumor diamete r was 2.5 cm, all were grade 1 or 2. The local recurrence rate was 7.4 % for group A and 21% for group B. Local recurrence was not correlated with tumor grade, location, or size but did correlate with tumor ulce ration. Conclusion: For selected early rectal cancers, surgical excisi on and fulguration offers better local control than endocavitary radia tion therapy, while survival was similar.