Observational studyInternational journal of colorectal disease2026
Long-term outcomes of pT1 rectal cancer after transanal endoscopic surgery: again, a word of caution on high local recurrence - a cohort study.
Observational study in International journal of colorectal disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Chemoradiotherapy and transanal endoscopic surgery versus transanal endoscopic surgery alone in T1N0M0 rectal cancer: a multicenter, randomized, controlled, phase III clinical trial (TAUTEM-T1 study).International journal of colorectal disease · 2026Trial
- Management of pT1N0M0 rectal cancer: the central role of pathology in therapeutic decisions.International journal of colorectal disease · 2026Article
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Authors and funding
7 authors.
Funding
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Abstract
purposeRecent evidence suggests that the local recurrence (LR) rate after local excision of pT1 rectal adenocarcinoma may be higher than previously estimated, particularly in large cohorts with extended follow-up. This study aimed to evaluate the LR rate and long-term oncological outcomes in patients with pT1 rectal adenocarcinoma treated with transanal endoscopic surgery (TES).
methodObservational cohort study including 824 consecutive patients who underwent TES at a single tertiary center between 2004 and 2021. Among them, 104 patients (12.6%) were diagnosed with pT1 rectal adenocarcinoma. Patients were excluded if they had received neoadjuvant or adjuvant chemoradiotherapy, had non-rectal tumors, a follow-up of less than 40 months, or were treated with surgical techniques other than TES.
resultsWith a median follow-up of 91 months (IQR: 84), 17 patients (16.3%) developed LR and 14 (13.5%) developed distant recurrence. Five-year rectal cancer-specific and overall survival rates were 95% and 74%, respectively. Among the 88 patients without histopathological or surgical high-risk factors, 13 (14.8%) experienced LR and 9 (10.2%) distant recurrence. Their five-year disease-free and overall survival rates were 95% and 74%, Multivariate analysis identified flat-ulcerated morphology as the only independent predictor of LR (OR 6.8; 95% CI 1.5-30.4; p = 0.01).
conclusionTES for pT1 rectal adenocarcinoma resulted in a 16.3% overall LR rate, and 14.8% among patients without known risk factors, emphasizing the need for improved patient selection and novel prognostic and therapeutic tools. These findings warrant confirmation in multicenter studies with standardized criteria and prolonged follow-up.
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