Local excision of early rectal cancer: A multi-centre experience of transanal endoscopic microsurgery from the United Kingdom

Table 1 Patients, tumour and operative characteristics, n (%)

Characteristics
Number of cases	222
Age (median)/years	71 (41-90)
Gender
Male	144 (64.9)
Female	78 (35.1)
Distance from AV (median)/cm	4.5 (0.5-30)
Tumor size (median)/mm	26 (1-140)
Preoperative pathology
Adenocarcinoma	201 (90.5)
Post RT cCR	3 (1.35)
Adenoma	16 (7.2)
Local recurrence	1 (0.45)
Carcinoid	1 (0.45)
Patient position
Lithotomy	72 (32.3)
Left lateral	47 (21.1)
Right lateral	31 (13.8)
Lloyd-Davies	8 (3.6)
Prone	9 (4)
Missing data	55 (24.7)
R0	171 (76.7)
Blood loss in ml (mode)	0 (0-100)
Operative time (mean)/minutes	90 (36-280)
Hospital-stay in days (median)/days	1 (0-133)
Salvage TME	42 (19.8)

AV: Anal verge; RT: Radiotherapy; cCR: Complete clinical response; TME: Total mesorectal excision.

Table 2 Pathologic features

Pathologic features	n (%)
Carcinoid	1 (0.45)
Adenoma	9 (4)
pT0	11 (4.9)
pT1	102 (45.9)
pT2	67 (30.2)
pT3	32 (14.4)

Table 3 Oncologic outcomes

Oncologic outcomes	n (%)
Total recurrences	35 (15.7)
Local recurrences only	19 (8.5)
Distant recurrences only	12 (5.3)
Synchronous Local and distant	4 (1.79)
DFS in months (median)	65 (3-146)
OS in months (median)	59 (0-146)

DFS: Disease-free survival; OS: Overall survival.

Table 4 Factors affecting disease-free survival and overall survival

Factors affecting survival	DFS		OS
	95%CI	P value	95%CI	P value
Age		P = 0.35 (NS)		P = 0.022
Gender		P = 0.83 (NS)		P = 0.174 (NS)
Male	120 (111-129.5)		96.6 (86.6-106.7)
Female	123.6 (110.9-136.3)		107.7 (93.6-120.7)
Distance from AV		P = 0.953 (NS)		P = 0.0001
Tumour size		P = 0.17 (NS)		P = 0.0001
pT	pT0: 111.3 (93-129.4); pT1: 123.8 (111.3-134.3); pT2: 118 (105.4-131.9); pT3: 94 (72.9-116)	P = 0.45 (NS)	pT0: 102 (79.5-125.7); pT1: 115 (104-126); pT2: 86 (75-97.3); pT3: 54.3 (42.5-66)	P = 0.000039
pN0	93.6 (76.5-110.7)		77.6 (58.7-96.5)
pN1	101.7 (81.4-121.9)	P = 0.82 (NS)	101.7 (86.9-116.5)	P = 0.57 (NS)
R0	123.2 (114.7-131.6)		105.7 (96.5-114.9)
R1	92 (72-112)	P = 0.047	74.7 (61.2-88.2)	P = 0.045
Salvage TME	92.5 (74-111.2)		111 (96.6-125.2)
No Salvage TME	110.3 (98-123)	P = 0.121 (NS)	101.4 (88.7-114.2)	P = 0.21 (NS)

OS: Overall survival; DFS: Disease-free survival; NS: Not statistically significant; AV: Anal verge; CI: Confidence interval; TME: Total mesorectal excision.

Table 5 Factors affecting local recurrence

Factors affecting local recurrences	Number of local recurrences, (%)	P value
pT stage		P = NS
pT0	0/11
pT1	9/92 (9.8)
pT2	8/62 (13)
pT3	4/28 (14.2)
R0 resections	14/157 (9)	P < 0.05
R1 resections	8/34 (23.5)

NS: Not statistically significant.