Symposium on carcinoma of colon and rectum: 2. Sphincter-preserving operations for rectal cancer.

At St. Mark's Hospital in London, England there has been a steady improvement over 20 years in the results of treatment of rectal cancer. The resectability rate has reached 95% and the overall operative mortality rate has declined to 2%. The corrected 5-year survival rate is about 70% for all who recover from the operation. It is unlikely that these figures can be bettered, so attention has been directed to the use of radiation therapy and adjuvant cytotoxic therapy, but so far no firm conclusions are possible on the benefits of either modality. In order to spare the patient a colostomy, local excision of the growth or the use of a transsphincteric approach can be considered, but few cases are suitable for either procedure or their more radical alternatives.