The Management of T1 Rectal Cancer in the North East of England
ABSTRACT NUMBER: (NESS _ 07)
AUTHORS
The Northern Surgical Trainees Research Association
AFFILIATIONS
The Northern Surgical Trainees Research Association
CORRESPONDING AUTHOR CONTACT EMAIL
moc.liamg@nabahsoldaf
MAIN ABSTRACT TEXT
Introduction
Traditional treatment of rectal cancer is major surgical resection. The management of early stages has evolved with increasing emphasis on organ preservation, with a number of endoscopic and local excision options. We explored the management and outcomes of T1 rectal cancer in the North East of England.
Methods
A retrospective, multi-centre, observational cohort-study of all patients with a pT1 rectal cancer across the North East between 1/1/2010 and 31/12/2017 was conducted. Our primary outcome was local recurrence.
Results
402 cases of T1 rectal cancer across 13 sites were identified. Median age was 68.4, and 35% were female. Characteristics of the index procedure are shown in the table below:
| Index Procedure | Number Performed (%) | R0 Resection Rate | Overall Complication Rate | Second Procedure Performed | Local Recurrence | Metastases | Overall
10-year Survival |
| Major Resection | 178 (43.8%) | 100% | 33.7% | 40 | 2.3% | 5.1% | 86.9% |
| Endoscopic | 140 (34.5%) | 68.2% | 6.4% | 2 | 1.4% | 1.4% | 87.7% |
| TEMS/TAMIS | 69 (17%) | 87.3% | 21.7% | 11 | 8.7% | 8.7% | 78.3% |
| Transanal | 6 (1.5%) | * | 16.7% | 3 | 16.7% | 0% | 83.3% |
| Total/Overall | 402 | 88.4% | 21.6% | 57 (14.1%) | 3.2% | 4.2% | 85.6% |
| p-Value | – | p<0.001 | p<0.001 | – | p=0.511 | p=0.769 | p=0.163 |
* missing data
Over the study duration was an increase in the TEMS/TAMIS procedure and a decrease in the endoscopic procedures. 22 of the 57 patients who had a second procedure had no residual disease.
Conclusion
Over time there was a trend to perform more local excision procedures. There were no statistically significant differences in local recurrence, metastases or overall survival in relation to the procedure performed.