THE ROLE OF TRANSANAL ENDOSCOPIC MICROSURGERY IN THE TREATMENT OF T1N0 RECTAL CANCER ? CASE SERIES AND REVIEW OF THE LITERATURE

Background: Currently, there has been an increasing trend toward transanal endoscopic microsurgery as a definitive treatment of T1 rectal cancer. Despite the promising results from the earlier series, the more recent studies reported a higher rate of local recurrences. Methods: A retrospective analysis of 20 patients with T1 rectal cancer managed by transanal endoscopic microsurgery is presented. Results: The patients were followed-up for mean 39.3 months. Local recurrences occurred in 5.3% of low-risk, 50% of high-risk T1 cases. The 3-year and 5-year cancer-specific survival in T1 group were 94.4% and 73.5%, respectively with mean time without LR was 81.5 months (90.5 months in the low-risk and 21 months in the high-risk group). Conclusion: The results corroborate the excellent prognosis for low-risk T1 cancers treated by TEM alone. For a high-risk T1 cancer adjuvant radiotherapy or conventional resection is highly recommended.