Abstract:

Objective To investigate the feasibility of transanal local excision of T2 rectal cancer after irinotecan chemotherapy combined shortterm radiotherapy.
MethodsThirtyseven patients with T2 rectal cancer who underwent irinotecan chemotherapy combined shortterm radiotherapy followed by transanal local excision from Jan. 2002 to Aug. 2008， were reviewed.
ResultsUnderwent preoperative treatment，complete responses and partial responses were achieved in 4（10.8％）and 27（73.0％）patients， respectively. Six patients were stable disease and no one occurred disease progress. The response rate was 83.8％ and disease control rate was 100.0％. Four patients underwent postoperative complications， 2 patients（5.4％） were anal stenosis, 1 patient（2.7％） were bleeding and 1 patient（2.7％） were rectovaginal fistula.A total of six patients（16.2％）postoperative recurrence and metastasis，3 patient were local recurrence， 2 patients were liver metastases，1 patient was local recurrence with liver metastasis. 3, 5year recurrence rates were 11.7％ and 14.1％，respectively. Three patients died of metastasis and recurrence. 3, 5-year overall survival were 94.6％ and 91.4％，respectively. ConclusionFor appropriate patients of T₂ rectal cancer，transanal local excision after irinotecan chemotherapy combined shortterm radiotherapy can be used as the clinical choice.