The indication of local excision for T2 rectal carcinomas

Background: Several researchers reported that local excision with or withou t postoperative chemo-radiation therapy is an alternative approach for sphi ncter preservation in patients with locally invasive rectal carcinoma. Howe ver, indications and long-term results have not yet been determined. Methods: Seventy-two patients with T2 colorectal carcinomas underwent bowel resection with regional lymph node dissection. The associations between ly mph node metastasis (LNM) and clinicopathologic factors were examined with special reference to the presence or absence of moderate to severe degree o f focal dedifferentiation or mucinous component at the invasive margin (unf avorable histology). Results: Multivariate logistic regression analysis revealed that both sex a nd unfavorable histology were significantly associated with LNM (P = 0.0102 , 0.0226, respectively). However, the associations between LNM and lymphati c invasion or tumor location were not statistically significant (P = 0.0947 , 0.1738). Conclusions: When locally resected T2 rectal carcinoma specimens have unfav orable histology at the invasive margin, additional bowel resection with ly mph node dissection should be recommended. (C) 2001 Excerpta Medica, Inc. A ll rights reserved.