Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul-Aug;30(4):245-250.
doi: 10.1097/PPO.0000000000000734.

Local Excision for Early-Stage Rectal Adenocarcinomas

Kristen Donohue  1 , Alexander Rossi  1 , Matthew P Deek  2 , Daniel Feingold  1 , Nell Maloney Patel  1 , Salma K Jabbour  2
Affiliations
Review

Local Excision for Early-Stage Rectal Adenocarcinomas

Kristen Donohue et al. Cancer J. 2024 Jul-Aug.

Abstract

Although total mesorectal excision (TME) remains the standard of care for rectal cancer, including early-stage T1/T2 rectal adenocarcinoma, local excision may be warranted for these early-stage tumors in a select group of patients who may decline surgery or may be nonoptimal surgical candidates. Operative approaches for transanal local excision include transanal endoscopic microsurgery or transanal minimally invasive surgery for tumors <4 cm, occupying <40% of the rectal circumference and <10 cm from the dentate line. The use of preoperative chemoradiation therapy may help to downstage tumors and allow for more limited resections, and chemoradiation may also be employed postoperatively. Local excision approaches appear to result in improved quality of life compared with TME, but limited resections may also compromise survival rates compared with TME. Multidisciplinary management and shared decision-making can allow for the desired patient outcomes.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest and Source of Funding: S.K.J. receives National Institutes of Health funding. The other authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

References

    1. Rosén R, Nilsson E, Rahman M, et al. Accuracy of MRI in early rectal cancer: national cohort study. Br J Surg. 2022;109:570–572. doi:10.1093/bjs/znac059. - DOI
    1. Garcia-Aguilar J, Pollack J, Lee SH, et al. Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. Dis Colon Rectum. 2002;45:10–15. doi:10.1007/s10350-004-6106-3. - DOI
    1. Gualdi GF, Casciani E, Guadalaxara A, et al. Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings. Dis Colon Rectum. 2000;43:338–345. doi:10.1007/bf02258299. - DOI
    1. Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol. 2018;28:1465–1475. doi:10.1007/s00330-017-5026-2. - DOI
    1. Kim NK, Kim MJ, Yun SH, et al. Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum. 1999;42:770–775. doi:10.1007/bf02236933. - DOI

LinkOut - more resources