In general, rectal carcinoids smaller than 1 cm can be safely removed by endoscopic excision. Excised specimens should be examined histologically to exclude muscularis invasion.[2,3,4,5]
Tumors measuring 1 cm to 2 cm should be investigated by transanal endosonography or magnetic resonance imaging. Absence of muscularis invasion or regional metastases may justify local excision. The outcome from treating a lesion between 1 cm and 2 cm is unclear. The metastatic risk is between 10% and 15%....
Standard treatment options for stage I colon cancer include the following:
Wide surgical resection and anastomosis.
Evidence (laparoscopic techniques):
The role of laparoscopic techniques [1,2,3,4] in the treatment of colon cancer was examined in a multicenter, prospective, randomized trial (NCCTG-934653, now closed) comparing laparoscopic-assisted colectomy (LAC) with open colectomy.
Three-year recurrence rates and 3-year overall survival rates were similar in the two groups. (Refer to the Primary Surgical Therapy section in the Treatment Option Overview section of this summary for more information.)
The quality-of-life component of this trial has been published and minimal short-term quality-of-life benefits with LAC were reported.[Level of evidence: 1iiC]
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Bokey EL, Moore JW, Chapuis PH, et al.: Morbidity and mortality following laparoscopic-assisted right hemicolectomy for cancer. Dis Colon Rectum 39 (10 Suppl): S24-8, 1996.
Franklin ME Jr, Rosenthal D, Abrego-Medina D, et al.: Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Five-year results. Dis Colon Rectum 39 (10 Suppl): S35-46, 1996.
Fleshman JW, Nelson H, Peters WR, et al.: Early results of laparoscopic surgery for colorectal cancer. Retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group. Dis Colon Rectum 39 (10 Suppl): S53-8, 1996.
Schwenk W, Böhm B, Müller JM: Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. A prospective randomized trial. Surg Endosc 12 (9): 1131-6, 1998.
Weeks JC, Nelson H, Gelber S, et al.: Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287 (3): 321-8, 2002.
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WebMD Public Information from the National Cancer Institute
February 25, 2014
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