Management of T1 carcinoma of the lower third rectum.

The earliest invasive carcinoma of colon and rectum is an invasion into the submucosa. For the TNM classification, these lesions are T1 Nx Mx. They present as an adenoma with invasive carcinoma, or a frank carcinoma. Local excision for T1 carcinoma of the rectum can be curative if the lesion is accessible for an adequate excision and if the lesion has not spread to the lymph nodes or distant metastasis. The key to success in local excision is selecting the lesions that have low risk of metastasis.