Skip to content

    Colorectal Cancer Health Center

    Font Size
    A
    A
    A

    Rectal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage I Rectal Cancer

    Stage I tumors extend beneath the mucosa into the submucosa (T1) or into, but not through, the bowel muscle wall (T2). Because of its localized nature at presentation, stage I has a high cure rate.

    Treatment options:

    Recommended Related to Colorectal Cancer

    Understanding Colon Cancer -- Diagnosis and Treatment

    Beginning at the age of 50, everyone should be screened regularly for colorectal cancer (earlier screening is recommended for some high-risk groups). There are several options. The traditional screening routine was for the doctor to perform a digital rectal exam once a year and for you to collect three stool samples to be tested for traces of blood. Also, every three to five years you would receive a sigmoidoscopy and a double-contrast barium enema to look at the lower part of the bowel. If anything...

    Read the Understanding Colon Cancer -- Diagnosis and Treatment article > >

    1. Wide surgical resection and anastomosis when an adequate low-anterior resection (LAR) can be performed with sufficient distal rectum to allow a conventional anastomosis or coloanal anastomosis.
    2. Wide surgical resection with abdominoperineal resection (APR) for lesions too distal to permit LAR.
    3. Local transanal or other resection [1,2] with or without perioperative external-beam radiation therapy (EBRT) plus fluorouracil (5-FU).

    There are three potential options for surgical resection in stage I rectal cancer: local excision, LAR, and APR. Local excision should be restricted to tumors confined to the rectal wall and that do not, on rectal ultrasound or magnetic resonance imaging, involve the full thickness of the rectum (i.e., not a T3 tumor). The ideal candidate for local excision has a T1 tumor with well-to-moderate differentiation that occupies less than one-third of the circumference of the bowel wall. Local excision should only be applied to very select patients with T2 tumors, as there is a higher risk of local and systemic failure.

    For patients with T1 and T2 tumors, no randomized trials are available to compare local excision with or without postoperative chemoradiation to wide surgical resection (LAR and APR). Investigators with the Cancer and Leukemia Group B (CALGB) enrolled patients with T1 and T2 rectal adenocarcinomas that were within 10 cm of the dentate line and not more than 4 cm in diameter, and involving not more than 40% of the rectal circumference, onto a prospective protocol,CLB-8984. Patients with T1 tumors received no additional treatment following surgery, whereas patients with T2 tumors were treated with EBRT (54 Gy of 30 fractions, 5 days/week) and 5-FU (500 mg/m2 on days 1 through 2 and days 29 through 31 of radiation). At 48 months median follow-up, the 6-year failure-free survival and overall survival (OS) rates for patients with T1 tumors were 83% and 87%, respectively. For patients with T2 tumors, the 6-year failure-free survival and OS rates were 71% and 85%, respectively.[3]

    1 | 2
    Next Article:

    Today on WebMD

    Colorectal cancer cells
    The right diagnosis is the most important factor.
    man with a doctor
    Our health check will steer you in the right direction.
     
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    bladder cancer x-ray
    Do you know the warning signs?
     
    bread
    ARTICLE
    Colon vs Rectal Cancer
    VIDEO
     
    New Colorectal Treatments
    VIDEO
    can lack of sleep affect your immune system
    FEATURE
     
    Cancer Facts Quiz
    QUIZ
    Virtual Colonoscopy
    VIDEO
     
    Picture of the Colon
    ANATOMY
    Vitamin D
    SLIDESHOW