Policy of local excision for early cancer of the colorectum.

A policy of local excision or total biopsy for early cancer of the colorectum, when this is technically possible, has been described. This is based on thorough histological examination of the excised specimen with special reference to the completeness of surgical excision, the depth of spread of the cancer into the bowel wall, and the histological grade of malignancy. The results of this policy in 119 patients treated by local excision only have been studied. There have been 10 recurrences but only five of these are regarded as policy failures. Because of these good results it is suggested that the policy as described should be regarded as an established alternative to partial colectomy, anterior resection, and abdominoperineal excision in carefully selected patients.