Journal of the Anus, Rectum and Colon
Online ISSN : 2432-3853
ISSN-L : 2432-3853
Original Research Article
Nonsurgical Management Following Local Resection for Early Rectal Cancer in Patients with High-risk Factors: A Single-institute Experience
Daisuke NishizakiNobuaki HoshinoKoya HidaYoshitaka NishikawaTakahiro HorimatsuSachiko MinamiguchiKatsuyuki SakanakaYoshiharu Sakai
Author information
JOURNALS OPEN ACCESS

2020 Volume 4 Issue 4 Pages 174-180

Details
Abstract

Objective: Additional surgery is considered for patients at high risk for lymph node metastasis (LNM) after local resection for early rectal cancer. Several factors are considered as indications for additional surgery, although there are currently no definitive criteria. This study aimed to clarify the need for additional surgery based on the number of risk factors for LNM and to evaluate the significance of submucosal invasion on recurrence.

Methods: Patients with early rectal cancer harboring risk factors for LNM who underwent local resection between March 2005 and December 2016 were retrospectively analyzed. Associations among the number of risk factors, prognosis, and additional treatment after local resection were investigated.

Results: A total of 29 eligible patients were classified into the surgery (n = 10), chemoradiotherapy (n = 7), and no-additional-treatment (NAT, n = 12) groups. Among the 29 patients, 15 patients (52%) with only one risk factor did not relapse. The NAT group harbored fewer risk factors for LNM, and 8 of the 12 patients (67%) had only deep submucosal invasion. Local recurrence occurred in one patient in the chemoradiotherapy group. The estimated 5-year overall survival rates were 88.9%, 75.0%, and 81.5% in the surgery, chemoradiotherapy, and NAT groups, respectively. There were no disease-specific deaths in the overall cohort.

Conclusions: In the present study, no recurrence occurred in patients who did not receive additional surgery with deep submucosal invasion as the only risk factor. A multicenter investigation is necessary to confirm the safety of nonsurgical options.

Fullsize Image
Information related to the author
© 2020 The Japan Society of Coloproctology

JARC is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Anyone may download, reuse, copy, reprint, or distribute articles published in the Journal for non-profit purposes if they cite the original authors and source properly. If anyone remixes, transforms, or builds upon the material, you may not distribute the modified material.
https://creativecommons.org/licenses/by-nc-nd/4.0/
Previous article Next article
feedback
Top