Local Excision of Rectal Cancer-Clinical Decision-Making

A small group of patients with “early” rectal cancers that have favorable characteristics can be cured by local excision, without the need for a radical resection. The key is very careful selection of patients, precise surgical techniques, fastidious histologic review of the specimens, and judicious use of postoperative adjuvant therapy. Recurrence after a local excision significantly worsens the prognosis of patients who had a relatively localized rectal cancer that has a high cure rate by radical resection alone. This article focuses on the indications and limitations of local excision of rectal cancer and highlights gaps in our knowledge that mandates further study.