Transanal Endoscopic Microsurgery Versus Laparoscopic Resections in 100 T2-n0 Rectal Cancers Following Neoadjuvant Treatment: A Prospective Randomized Trial with Five Years Minimum Follow-up

Background: Aim of this study was to compare the oncological results of local excision performed with Transanal Endoscopic Microsurgery (TEM) versus Laparoscopic Resection (LR) with total mesorectal excision in the treatment of T2 N0, G1-2 rectal cancer following NT in both arms, with a 5 years minimum follow-up.
Methods: In the period comprised between April 1997 and April 2004, 100 patients staged at admission as T2 N0, G1-2 rectal cancer with a tumour diameter lower than 3 cm and located within 6 cm from the anal verge were enrolled: 50 were randomized to TEM and 50 to LR. Patients in both groups were previously underwent high dose radiotherapy (5,040 cGy in 28 fractions over 5 weeks) combined with continuous infusion of 5-Flurouracil (200 mg/m2/day).
Results: At minimum follow-up of 5 years 4 local recurrence (8.0 %) were observed after TEM and 3 (6 %) after LR . Distant metastases occurred in 2 (4%) case after TEM and in 2 (4%) pts after LR. The probability of disease-free survival at the end of follow-up was 91% in TEM group (95% Confidence Interval=79%-99%) and 93 % in LR group B (95% Confidence Interval=78%-99%).
Conclusions: The study shows similar results between the two arms in terms of local recurrences, distant metastases and probability of survival for rectal cancer.

Session: Podium Presentation

Program Number: S084

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