In a nutshell
This study investigated long term rectal cancer outcomes in patients who received chemotherapy, radiation therapy, and transanal microsurgery. Researchers suggested that this treatment improves treatment outcomes and quality of life of patients.
Some background
The standard treatment for rectal cancer is surgery. However, this surgery is associated with high rates of side effects. After a surgery, 60% of patients experience a bowel disorder. This might affect body image and quality of life.
Transanal endoscopic microsurgery (TEM) is a less invasive procedure for the removal of early rectal tumors. A tube with a camera is inserted through the rectum and tumors are removed without the need of a surgical opening. Prior studies showed that TEM as associated with better treatment outcomes in patients that responded well to chemotherapy and radiation.
However, these studies had a short follow-up period. Bigger studies are necessary to investigate the long-term outcomes of TEM.
Methods & findings
This study included information about 55 patients with rectal cancer. These patients were treated with chemotherapy and radiation therapy followed by TEM. Patients were closely followed up for 53 months to detect local recurrences (when cancer comes back at the same place) and/or metastasis (spread to other parts of the body). Surgery complications and quality of life were assessed using questionnaires.
Following chemotherapy and radiation, 47 patients (85%) underwent TEM. The 5-year local recurrence rate was 7.7%. The 5-year disease-free survival (DFS; survival time from treatment without signs of cancer) was 81.6% and overall survival was 82.8%. Patients who underwent local TEM described an improved emotional well-being and quality of life.
Major bowel complications were seen in 50% of patients and 22% had no side effects.
The bottom line
This study concluded that TEM is associated with better rectal cancer outcomes and improved quality of life.
The fine print
The data in the patient-filled questionnaires might have been incomplete. This may have an effect on the results.
Published By :
JAMA surgery
Date :
Oct 10, 2018
