Is localized surgery safe in early stages of rectal cancer?

This study investigated the safety of localized surgery compared with total mesorectal excision (TME; bowel and lymph nodes around the tumor are removed) in early stages (0 and 1) of rectal cancer. Researchers reported that localized surgery is as efficient as TME in early stages of rectal cancer. 

Chemotherapy and radiation therapy followed by TME increases tumor control in stage 2 and 3 rectal cancer. However, a high number of patients experience post-surgery complications. Prior studies showed that localized surgery is as equally efficient as TME in stages 2 or 3 rectal cancer. Localized surgery is now being considered as a less aggressive treatment option. However, there is no information on the efficacy of localized surgery in early stages (0 or 1) of rectal cancer

The objective of this study was to investigate the efficacy of localized surgery in comparison to TME in patients with early stages of rectal cancer who received chemotherapy and radiation therapy.

This study reviewed the outcomes of 304 patients who underwent localized surgery or TME after chemotherapy and radiation therapy. Overall survival (OS, time from treatment until death from any cause) and disease-free survival (DFS, time from treatment until disease return) were measured.

5-year DFS was 95.2% in localized surgery patients and 91.6% in TME patients. 5-year OS of localized surgery patients was 96.6%, and 88% in TME patients.

This study showed that localized surgery has similar efficacy rates in comparison with TME in early stage rectal cancer patients who received chemotherapy and radiation therapy. 

This study was small with a limited number of participant patients. This was a retrospective study, looking back at patients already treated. A larger, randomized trial is needed.