Patterns of failure following local excision and local excision and postoperative radiation therapy for invasive rectal adenocarcinoma

C. G. Willett, J. E. Tepper, S. Donnelly, W. C. Wood, P. C. Shellito, G. V. Rodkey, M. A. Stracher, Carolyn Compton

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

The clinical course of 40 patients undergoing conservative surgical excision and 26 patients undergoing local excision and postoperative radiation therapy of rectal carcinoma was reviewed. Surgical procedures were transanal excision (55 patients), Kraske procedure (ten patients), and fulguration (one patient). The five-year actuarial survival, disease-free survival, and local control of all 66 patients were 70%, 77%, and 63%, respectively. For patients undergoing local excision alone, the prognostic features of lesion size greater than 3 cm, poorly differentiated histology, invasion into muscularis propria or deeper, moderate to marked stromal fibrosis, vascular or lymph vessel invasion, fragmented resection, and positive resection margins were associated with a local failure rate of 20% or greater. Of the 26 patients receiving postoperative radiation therapy, four patients have developed local failure. For subgroups of patients with small rectal carcinomas confined to the mucosa, local excision may be a reasonable alternative to abdominoperineal resection. For tumors with deeper invasion but limited to the bowel wall, local excision plus pelvic irradiation can be offered to preserve anorectal function.

Original languageEnglish (US)
Pages (from-to)1003-1008
Number of pages6
JournalJournal of Clinical Oncology
Volume7
Issue number8
StatePublished - 1989
Externally publishedYes

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Adenocarcinoma
Radiotherapy
Carcinoma
Lymph
Disease-Free Survival
Blood Vessels
Histology
Mucous Membrane
Fibrosis
Survival
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Patterns of failure following local excision and local excision and postoperative radiation therapy for invasive rectal adenocarcinoma. / Willett, C. G.; Tepper, J. E.; Donnelly, S.; Wood, W. C.; Shellito, P. C.; Rodkey, G. V.; Stracher, M. A.; Compton, Carolyn.

In: Journal of Clinical Oncology, Vol. 7, No. 8, 1989, p. 1003-1008.

Research output: Contribution to journalArticle

Willett, CG, Tepper, JE, Donnelly, S, Wood, WC, Shellito, PC, Rodkey, GV, Stracher, MA & Compton, C 1989, 'Patterns of failure following local excision and local excision and postoperative radiation therapy for invasive rectal adenocarcinoma', Journal of Clinical Oncology, vol. 7, no. 8, pp. 1003-1008.
Willett, C. G. ; Tepper, J. E. ; Donnelly, S. ; Wood, W. C. ; Shellito, P. C. ; Rodkey, G. V. ; Stracher, M. A. ; Compton, Carolyn. / Patterns of failure following local excision and local excision and postoperative radiation therapy for invasive rectal adenocarcinoma. In: Journal of Clinical Oncology. 1989 ; Vol. 7, No. 8. pp. 1003-1008.
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