Long-term Outcomes of Transanal Endoscopic Microsurgery for Clinical Complete Response After Neoadjuvant Treatment in T2-3 Rectal Cancer

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2021 Jul 7

PMID 34231071

Citations 3

Authors

Javier Ernesto Barreras Gonzalez

Haslen Caceres Lavernia

Jorge Gerardo Pereira Fraga

Solvey Quesada Lemus

Affiliations

Soon will be listed here.

Abstract

Background: Organ sparing by the transanal endoscopic microsurgery (TEM) procedure is a treatment for patients with locally advanced rectal cancer after chemoradiotherapy (CRT) and complete clinical response (cCR).

Aims: To assess the surgical and long-term oncological outcomes of TEM for the treatment in T2-3 rectal cancer after CRT and cCR.

Methods: This study was a retrospective review of a prospective database of patients with rectal cancer who underwent TEM after CRT and cCR from April 2011 to March 2020.

Results: 52 patients underwent TEM during a period of 9 years. This group of patients included 27 females and 25 males. The median age was 62 (32-86) years, lesion size was 2.5 (1-4) cm, and lesion distance from the anal verge 7.3 (4-10) cm. Median operative time was 79.5 (25-120) min and hospital stay was 1 day (14 h-4 days). Morbidity rate was 13.5% and reoperation rate due to major complications was 3.8%. Final histological findings confirmed 34 (65.4%) patients with ypT0, 7 (13.5%), 6 (11.5%), and 5 (9.6%) patients with carcinoma ypT1, ypT2, and ypT3, respectively. After a median follow-up period of 86 (5-107) months, 1 (2.4%) patient had local recurrences and 3 (7.3%) distant metastases. The 5-year disease-free survival was 91.7% and 5-year overall survival 89.5%.

Conclusion: Our experience has shown significant rates of ypT0 and ypT1 associated with excellent long-term results. Performing TEM to treat T2-3N0 rectal cancer after CRT and cCR appears to be an oncologically safe and effective procedure.

Citing Articles

Short- and long-term outcomes in ypT2 rectal cancer patients after neoadjuvant therapy and local excision: a multicentre observational study.

Peltrini R, Castiglioni S, Imperatore N, Ortenzi M, Rega D, Romeo V Tech Coloproctol. 2022; 27(1):53-61.

PMID: 36239872 PMC: 9807481. DOI: 10.1007/s10151-022-02712-y.

Prognosis of Patients Over 60 Years Old With Early Rectal Cancer Undergoing Transanal Endoscopic Microsurgery - A Single-Center Experience.

Zhang M, Zhang Y, Jing H, Zhao L, Xu M, Xu H Front Oncol. 2022; 12:888739.

PMID: 35774121 PMC: 9239430. DOI: 10.3389/fonc.2022.888739.

[Complete response after neoadjuvant therapy of rectal cancer: implications for surgery].

Kastner C, Petritsch B, Reibetanz J, Germer C, Wiegering A Chirurg. 2021; 93(2):144-151.

PMID: 34878582 DOI: 10.1007/s00104-021-01540-4.

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