Are there patients with stage i rectal carcinoma at risk for failure after abdominoperineal resection?

Abstract

The clinical courses of 64 patients undergoing abdominoperineal resection for Stage I lower rectal carcinoma (tumors confined to the muscularis propria without lymph node involvement) were reviewed to identify subsets at risk for failure. Twelve of 12 patients with tumors limited to the submucosa remained disease free without evidence of recurrence. Of the 52 patients with muscularis propria involvement, there have been eight failures with three patients having local failure only, three patients with local failure and distant metastases, and two patients with distant metastases only. The 6‐year actuarial disease‐free survival, local control, and freedom from distant metastases rates for patients with tumors invasive of the muscularis propria were 80%, 84%, and 88%, respectively. Patients with tumors exhibiting vascular/lymph vessel involvement were at even higher risk for failure. Although adjuvant treatment is infrequently advised for these patients, the use of radiation therapy and chemotherapy should be reconsidered for patients with Stage I lower rectal carcinoma, specifically for patients with tumors invasive of the muscularis propria with vascular/lymph vessel involvement.

Recurrence in patients with stage I colorectal cancer

“…Studies of CRC have reported recurrence rates between 0 and 16% for patients with stage I disease. [11][12][13][14][15][16][17][18][19][20][21] This can possibly be explained by differences in surgical technique, follow-up times, retrospective design and the small sample size of most studies. In our series, even patients with the most favourable pathological features (i.e.…”

Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer

“…T2 stage tumor [8-10], lymphovascular invasion [7, 8], lower rectal lesions [9], male sex [7], a poorly-differentiated carcinoma [7] and high preoperative carcinoembryonic antigen value [10] were identified as influential factors related to the recurrence of stage I colorectal cancer in previous studies. Table 5 summarizes the results of previous studies related to the recurrence of first-stage colorectal cancer and compares them with the results of this study.…”

Transanal Endoscopic Microsurgical Resection of pT1 Rectal Tumors

“…5 Local recurrence of pT1 tumors after abdominoperineal resection is low (0-10 percent) with a 0 percent local recurrence rate reported in some series. 17,18 Overall five-year survival rates for pT1 rectal cancers radically excised range from 78 to 100 percent. Local recurrence rates after conventional transanal excision without chemoradiation range from 0 to 33 percent for pT1 disease.…”