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Outcomes for early rectal cancer managed with transanal endoscopic microsurgery

A 5-year follow-up study

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This study aimed to evaluate the long-term risk of local and distant recurrence as well as the survival of patients with early rectal cancer treated using transanal endoscopic microsurgery (TEM).


The study reviewed 69 patients with Tis/T1/T2 rectal cancer treated using full-thickness excision between 1991 and 1999. The pathology T-stages included 25 Tis, 23 T1, and 21 T2. The median follow-up period was 6.5 years (range 5–10.2 years).


The overall local recurrence rate was 8.7%. The 5-year local recurrence rate was 8% for Tis, 8.6% for T1, and 9.5% for T2. All six patients with recurrence were managed surgically. The 5-year disease-specific survival rate was 100% for Tis, 100% for T1, and 70% for T2. The overall cancer-related mortality rate was 7.2%.


After local excision of early rectal cancer, a substantial local recurrence rate is observed. Patients with recurrent Tis/T1 cancers who undergo a salvage operation may achieve good long-term outcome. Local treatment without adjuvant therapy for T2 rectal cancers appears inadequate.

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Author information

Correspondence to F. Stipa.

Additional information

Presented in part at the Annual Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting, Ft Lauderdale, FL, USA, 13–16 April 2005

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Stipa, F., Burza, A., Lucandri, G. et al. Outcomes for early rectal cancer managed with transanal endoscopic microsurgery. Surg Endosc 20, 541–545 (2006).

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  • Adjuvant therapy
  • Rectal cancer
  • Transanal endoscopic microsurgery