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North Tees University Hospital Audit of T1 Rectal Cancers September 2013 – August 2014

North Tees University Hospital Audit of T1 Rectal Cancers September 2013 – August 2014. Nicola Maguire Teaching fellow General Surgery 12/09/2014. Aims. Appraise the management of T1 rectal cancer within our local unit

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North Tees University Hospital Audit of T1 Rectal Cancers September 2013 – August 2014

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  1. North Tees University HospitalAudit of T1 Rectal CancersSeptember 2013 – August 2014 Nicola Maguire Teaching fellow General Surgery 12/09/2014

  2. Aims • Appraise the management of T1 rectal cancer within our local unit • To ensure patients are being stratified according to risk and managed appropriately

  3. Methods • Retrospective audit of prospectively collected data • MDT database searched for T1 rectal tumours • Between September 2013 and August 2014 • Management and outcome data collected from electronic records/case notes

  4. Results • 11 patients diagnosed with T1 rectal cancer • 5 females, 6 males • Mean age 66 years(range 51-88) • 4 bowel screening patients, remainder referred as 2 week rule

  5. Results

  6. EMR • 3 patients • Histology showed adenocarcinoma ranging from a microscopic focus to 13mm • Completely excised • No further intervention

  7. TREC trial • 1 patient randomised to neo-adjuvant radiotherapy + TEMS • TEMS converted to single incision laparoscopic anterior resection as resectoscope was unable to reach area • Histopathology: 7mm, Grade 1, T1Sm3 adenocarcinoma within 37mm high grade TVA • 0/19 nodes • Completely excised

  8. TEMS • 2 patients underwent TEMS as definitive treatment • 1 patient opted for radiotherapy following discussion regarding risk of recurrence

  9. TEMS with subsequent radical surgery • 2 patients underwent TEMS followed by radical surgery ( 1 anterior resection and 1 APER)

  10. Radical Surgery 3 patients went straight to radical surgery

  11. Conclusion • Significant variation in management of T1 rectal cancer • Potential for over/under treatment • Require further studies to assess optimal management of these patients with early disease

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