Objective:
To compare two techniques for the local treatment of "early" rectal adenocarcinoma.
Design and Study Participants:
A retrospective comparison of 27 patients who underwent transanal disk excision and fulguration (group A) and 38 patients who underwent transanal endocavitary radiation (group B).
Setting:
Inpatient and outpatient.
Intervention:
Group A patients had rectal adenocarcinoma treated with disk excision and fulguration. Group B patients received 100 to 125 Gy in four to five fractions using the Phillips RT-50 unit.
Main Outcome Measures:
Survival and local recurrence.
Results:
The median follow-up for group A was 68 months; for group B, 38 months. The mean tumor diameter was 2.5 cm, all were grade 1 or 2. The local recurrence rate was 7.4% for group A and 21% for group B. Local recurrence was not correlated with tumor grade, location, or size but did correlate with tumor ulceration.
Conclusion:
For selected early rectal cancers, surgical excision and fulguration offers better local control than endocavitary radiation therapy, while survival was similar.(Arch Surg. 1993;128:1028-1032)