BACKGROUND: Transanal endoscopic microsurgery is superior to other methods of local excision of @entity5 , but few studies report long-term follow-up data. OBJECTIVE: This study investigated the use of transanal endoscopic microsurgery alone as curative and compromise therapy based on long-term disease recurrence and mortality. DESIGN: This was a retrospective review of prospectively collected data. SETTINGS: The study was conducted at a tertiary care university medical center. @entity1 : The study included 133 @entity1 treated between 1985 and 2007. There were 3 groups, including transanal endoscopic microsurgery in curative intent (low-risk @entity189 , including @entity2558 , G1/2, L0, and LX with clear margins and a minimal distance between @entity5 and resection margin of >1   mm (N = 64) or clear margins only (N = 18 ))) and as compromise therapy (high-risk or incompletely resected @entity189 ; N = 51). MAIN OUTCOME MEASURES: Log-rank tests were used to compare overall and cancer-specific survival. RESULTS: The median follow-up time was 8.6 years (range, 0.2-25.1 years), and a total of 131 of 133 @entity1 (98.5%) were followed >5 years or until @entity204 . The preoperative diagnosis of @entity189 was not associated with belonging into 1 of the 3 categories. In @entity1 with low-risk completely (>1   mm) resected @entity189 , the 5- and 10-year local recurrence rates were 6.6% and 11.6%. In @entity1 with high-risk or incompletely resected @entity189 , the rates were 32.5% and 35.0% (p = 0.006). The 5- and 10-year cancer-specific survival rates for low-risk @entity1 were 98.0% and 91.0% and 84.3% and 74.3% for high-risk @entity1 (p = 0.05). LIMITATIONS: The study was limited by its retrospective design and small subgroups. CONCLUSIONS: The high cancer-specific survival justifies transanal endoscopic microsurgery alone as curative treatment in low-risk @entity189 . Complete resection is essential to lower the risk of local recurrence. The high local recurrence rate in @entity1 with high-risk @entity189 restricts the use of TEM alone as compromise therapy.

Long-term Oncologic Outcome After Transanal Endoscopic Microsurgery for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity2558 :: ('58492', 'Gene') :: ['pT1'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'rectal cancer'] @entity189 :: ('MESH:D002277', 'Disease') :: ['rectal carcinoma', 'carcinoma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity189 :: (MESH:D002277,Disease) :: ['Rectal Carcinoma']
