Transanal Endoscopic Microsurgery (TEM) excision of locally advanced rectal cancers (pT2, pT3)

TEM is an accepted method of locally excising superficial (pT1) rectal cancers. It is controversial whether this technology is appropriate for cure of more advanced lesions. We retrospectively identified 35 patients (28 pT2, 7 pT3) with rectal cancer, treated with TEM +/- radiation and chemotherapy or radical surgery between 1991 and 2007. Of the pT2’s, mean patient age was 73.4 years, mean distance from the anal verge was 5.3 cm, mean tumor size was 3.8 cm. Outcome is shown below.

TEM alone is not sufficient treatment for these lesions. When results are pooled for the 2 stages, radiation/chemotherapy in combination with TEM eradicates disease in 89%, no local or distant failures were noted. When radical surgery is performed after TEM, no evidence of disease occurred during follow-up in 60%, no local recurrences were noted, however 40% recurred at distant sites. Combining RT/chemo with TEM may be appropriate for elderly patients with pT2 or pT3 cancers.

Session: Poster

Program Number: P380

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