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Title of Journal: Int J Colorectal Dis

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Abbravation: International Journal of Colorectal Disease

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Springer Berlin Heidelberg

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DOI

10.1007/bf01544996

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1432-1262

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Local excision of low rectal cancer treated by che

Authors: Clotilde Debove Nathalie Guedj Ecoline Tribillon Léon Maggiori Magaly Zappa Yves Panis
Publish Date: 2016/03/07
Volume: 31, Issue: 4, Pages: 853-860
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Abstract

The purpose of this study is to assess if local excision LE could be proposed if suspicion of complete tumor response CR after neoadjuvant chemoradiotherapy CRT for low rectal cancer LRC and this despite a potential risk of nodes N+ or other tumor deposits OTD left in place The aim was to assess in patients with LRC treated by CRT a pathologic results of LE and total mesorectal excision TME in case of preoperative suspicion of CR and b the risk of N+ or OTD on TME if ypT0TisT1 tumorAmong 202 patients with LRC after CRT 33 16  with suspicion of CR underwent LE n = 20 because of comorbidities and/or indication of definitive stoma or TME n = 13 Pathologic examination of LE and TME specimens and oncological outcomes were assessed Furthermore 40/202 patients with pathologic CR on TME specimen ypT0TisT1 were assessed for possible N+ or OTDIn the 33 patients with suspicion of CR a after LE tumor was ypT0TisT1 in only 15/20 cases 75  b after TME tumor was ypT0TisT1 in only 7/13 cases 54  Among 40 patients with ypT0TisT1 tumor on TME specimen 4 10  presented N+ and/or OTDIn LRC with suspicion of CR after CRT LE deserves a word of caution 25  of patients have in fact ypT2T3 tumors Furthermore in patients with ypT0Tis or T1 on TME specimen a 10  risk of N+ and/or ODT is observed Thus patient with suspicion of CR after CRT and treated by LE is exposed to a possible incomplete oncologic treatment

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