Bericht zum 1. Workshop zur lokalen Exzision von Rektumkarzinomen
| العنوان: | Bericht zum 1. Workshop zur lokalen Exzision von Rektumkarzinomen |
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| المؤلفون: | T Junginger, T Borschitz |
| المصدر: | Zentralblatt für Chirurgie. 132:99-105 |
| بيانات النشر: | Georg Thieme Verlag KG, 2007. |
| سنة النشر: | 2007 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.diagnostic_test, Colorectal cancer, business.industry, medicine.medical_treatment, Microsurgery, medicine.disease, Proctoscopy, Surgery, medicine.anatomical_structure, Tumor budding, medicine, Carcinoma, Resection margin, business, Lymph node, Abdominal surgery |
| الوصف: | To determine the significance of local excision (LE) of rectal cancer and discuss oncologic results, a 1st Workshop on LE of rectal cancer was held at the Department of General und Abdominal Surgery, Johannes Gutenberg-University Mainz, Germany. The option of broadening the indication for local excision after neoadjuvant radiochemotherapy (nRCT) of rectal cancer was to be assessed. Local excision of "low risk" T 1 carcinomas was rated as oncologically adequate therapy with good functional results and low complication rates. Transanal endoscopic microsurgical (TEM) resection was the preferrred technique. Pre-requisite for the achievement of low recurrence rates (5 %) is an R0 resection with a safety margin of at least 1 mm (R < or = 1 mm) without tumor fragmentation, because otherwise possible tumor cell displacement and RX resection may not allow an assessment of the resection margin. "high risk" tumors or T 2 carcinomas were not considered an indication for local excision. To identify additional histological risk factors for the oncological outcome (sm-level, tumor budding, mucinous component, perineural infiltration, etc.) the initiation of a multi-center register study (LERC = local excision of rectal cancer) was suggested and is now in preparation. If the finding after TEM resection is not a "low risk" T 1 carcinoma, but a "high risk" situation or a T 2 tumor, immediate reoperation is advised resulting in similar outcomes as compared to primary conventional surgery. A literature analysis of LE after neoadjuvant RCT of T 2/3 rectal cancers showed a local recurrence rate of 0 % for ypT 0 and of 5 % for ypT 1 findings (studies with small patient collectives and short follow-up periods). The lymph node status of T 2 / 3 carcinomas after nRCT is unclear. More advanced/primary not resectable tumors (T 3 / 4) showed lymph node metastases in 5 % for ypT 0 and in 12 % for ypT 1 findings after nRCT, suggesting that for earlier T categories lower rates can be expected. On the basis of these favourable results a prospective multi-center study will be initiated. A study protocol will be established during the 2nd Workshop on LE of rectal cancer in Mainz. |
| تدمد: | 1438-9592 0044-409X |
| DOI: | 10.1055/s-2007-960622 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::b6d0aea0fdd7240c26e181d706abd005 https://doi.org/10.1055/s-2007-960622 |
| رقم الانضمام: | edsair.doi...........b6d0aea0fdd7240c26e181d706abd005 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14389592 0044409X |
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| DOI: | 10.1055/s-2007-960622 |