A 67 year-old male patient with no medical history, diagnosed in April 2013 of a rectal cancer at 4 cm of the anal verge. Tumor staging was T2N0 at MRI and USE. No distant metastasis. RT – QT subsequently were performed. In MRI after treatment we observed a great radiological response compared to the previous exploration. After consensus with the patient a resection by TAMIS was performed. Pathology reported absence of neoplasia (pTxN0). Correct controls until two years later, a biopsy from the previous scar of resection showed rectal mucosa fragments with changes of tubular adenoma with areas of high-grade dysplasia and affected margins. At the moment no abnormal lymph nodes by USE, normal rectal wall, no other focal lesions. No distant disease.
Which would be your therapeutic approach to follow at that moment?
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