Further evidence for preoperative chemoradiotherapy and transanal endoscopic surgery (TEM) in T2-3s,N0,M0 XXXX .

@entity1 @entity137 @entity416 @entity5 @entity13401 @entity420 @entity1487
PURPOSE: Preoperative chemoradiotherapy and local excision via transanal endoscopic surgery (TEM) in T2-3s,N0,M0 @entity5 achieve promising results in selected @entity1 . We describe our long-term follow-up experience with this combination, and evaluate complete clinical and pathological responses, local recurrence and overall survival. METHODS: The prospective observational follow-up study carried out since 2007. Out of 476 consecutive @entity1 treated with TEM, we selected those with @entity420 of low or moderate grade of differentiation, clinical stages T2-superficial T3,N0,M0, who refused radical surgery. Preoperative chemoradiotherapy comprised @entity1487 or @entity416 combined with radiotherapy at a dose of 50.4  Gy. TEM was performed after 8 weeks. Complications were recorded and long-term follow-up was conducted. RESULTS: Fifteen @entity1 undergoing preoperative chemoradiotherapy and TEM (median age 76  years, 95  % CI 70.3-80.4, and median follow-up 38  months, 95  % @entity13401 -44) were studied. No local recurrence was observed, and only one @entity1 (6.7  %) presented systemic relapse. The overall survival was 76  %. Complete clinical response was achieved in seven @entity1 (46.7  %) and complete pathological response in four (26.7  %). With regard to @entity137 associated with neoadjuvant treatment, four @entity1 (26.7  %) developed grade 3 adverse effects; no grade 4 or 5 adverse effects were observed. There was no postoperative mortality. CONCLUSIONS: The results of our study, with a response rate of 26.7  % and without local relapse, support the treatment of T2-3s,N0,M0 of @entity5 with preoperative chemoradiotherapy and local excision (TEM).
