Indication of Surgical Therapy for Early Rectal Cancer

Yuji Inoue, Mamoru Suzuki, Katsutoshi Yoshida, Toru Tezuka, Ken Takasaki, Yoko Murata, Shigeru Suzuki

Institute of Gastroenterology, Tokyo Women's Medical University

Two hundred fifty five patients were selected for this study to evaluate appropriate management for early cancer of the rectum. One hundred eighty two patients had mucosal cancer and 73 had submucosal cancer. No patients had lymph node metastasis with mucosal cancer or submucosal cancer limited in sm1, therefore endoscopic resection or local resection is feasible those patients. The deeper in submucosa the cancer invasion, the greater the incidence of vascular invasion and lymph node metastasis. But the incidence of lymph node metastasis was low (10%), therefore radical resection, such as abdominoperineal resection of the rectum (APR), should not be avoided. The depth of cancer invasion of patients with lymph node metastasis was deeper than sm2, and these patients had vascular invasion. Therefore the radical resection with lymph node dissection should be indicated only if the patients have both deeper than sm2 and vascular invasion which are confirmed by the specimen after endoscopic resection or local resection.

Key words
early rectal cancer, local resection

Reprint requests
Yuji Inoue Institute of Gastroenterology, Tokyo Women's Medical University
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JAPAN

Accepted
September 16, 1998

To read the PDF file you will need Abobe Reader installed on your computer.