Criteria for the selection of rectal cancers for local treatment

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Abstract
Local treatment methods were used for many years for palliation of inoperable cases. Twenty-eight low rectal cancers were treated by electrocoagulation, with a 4 yr survival rate of 60%. In some cases electrocoagulation was supplemented by external radiation, and the 5 yr survival rate in this series was 68%. The use of local contact radiotherapy was described in 106 patients, with a 70% 5 yr survival. Patients are spared a permanent colostomy and the mortality risk associated with rectal excision. The primary growth may not be eradicated and patients with lymph node metastases will not be cured. Only those patients with small mobile tumors are suitable for local treatment. Annular and poorly differentiated tumors should not be treated with local methods. Since surgical mortality rates increase in the elderly and patients who are unfit for medical reasons, electrocoagulation or local contact radiotherapy may be the treatment of choice for small polypoid tumors.