Tumor recurrence after transanal excision of stage I rectal cancer in comparison with radical resection

Introduction: In the case of T1 low-risk rectal cancer, transanal excision is an established method. Now the question arises whether we can also treat higher stages, i.e. T1 high-risk and T2 tumors, by transanal excision with an acceptable recurrence rate. Method: The hospital notes of 152 patients treated by radical resection and transanal excision were examined retrospectively with special regard to the rate of recurrence after an average follow-up of 9.5 years. Results: Twenty-five patients were treated by rectal exstirpation, 105 by anterior resection. In 22 cases local tumor excision was performed: in 12 T1 carcinomas with curative intent and in 10 T2 carcinomas as a minimally invasive procedure for high-risk patients. Recurrence rates were between 8 % and 9 % in the three different groups. Conclusions: We recommend transanal excision with curative intent only in T1 low-risk tumors. Local excision is seen as an alternative minimally invasive treatment for patients in poor general condition with T2 carcinomas.