Colorectal Cancer An End Stage Disease - amazonia.fiocruz.br

Colorectal Cancer An End Stage Disease Video

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Treatment of early rectal cancer is evolving towards organ-preserving therapy which includes endoscopic resection and transanal approaches. We considered these outcomes alongside conventional major surgery using total mesorectal excision TME for early Coloretal disease. All patients identified at MDT with early stage rectal cancer at our institution between and were included. Long-term outcomes in terms of local recurrence, survival and procedure-specific morbidity were analysed.

In total, patients with rectal cancer were identified, of which were included based on their pre-operative identification at the MDT on the basis that they had node-negative early rectal cancer. There were no significant differences in overall survival rates and cancer-specific survival see more the three treatment groups. Rectal cancer has conventionally been treated with major surgical resection based on the principles of total mesorectal excision TME [ 1 ]. Although this approach has considerably reduced local recurrence and improved survival, it is associated with significant risk of morbidity including sexual, urinary or bowel dysfunction [ 12 ].

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Over the last few years, there has been increasing interest in developing organ-preserving approaches which would not subject patients to these risks [ 1345 ]. Initial reports of using an organ-preserving approach were focussed on patients treated with neo-adjuvant chemoradiation. Similarly, with the development of Diseaes mucosal resection EMR and endoscopic submucosal Colorectal Cancer An End Stage Disease ESDit is now possible to resect more advanced polyps and early cancers safely [ 78910 ].

Given the availability of expertise in all three of these techniques at our institution, this study seeks to demonstrate how the different treatment modalities are related to see whether it can guide clinical decision-making to achieve the optimal outcome.

Material and methods

Patients with T2 rectal cancer pre-operative as recorded at MDT and T2 or higher post-operative were excluded for this study. Clinical data regarding patient characteristics, diagnostic Stqge, tumour characteristics, histology reports, TNM stage 7th or 8th edition regarding year of diagnosistreatment, and follow-up were extracted from this database and were analysed retrospectively [ 1617 ]. Treatment decision was made by the patient and clinician based on MDT guidance following the valid guideline at time of diagnosis.

The reason behind treatment decisions was not always documented in detail and therefore could not https://amazonia.fiocruz.br/scdp/essay/benedick-and-beatrice-argument-quotes/this-source-is-very-closely-related-to.php analysed in this study. Treatment-related complications were reported up to days post procedure. If patients underwent more than one treatment e. The first endoscopy site check needed to show a healthy scar without signs of residual tumour if patients we considered for no further treatment but follow-up only. Recurrence was defined as local recurrence or appearance of metastatic disease. Coporectal curves were drawn using the Kaplan—Meier method.

Differences between Kaplan—Meier curves were tested using the log-rank test.]