Is local excision adequate for stage I rectal cancer?

Rectal cancer is a significant source of morbidity and mortality in patients. Although survival rates have improved with advances in surgical techniques and adjuvant therapy, these interventions are nonetheless associated with significant morbidity. Local excision has been suggested as an alternative surgical option that enables preservation of the anal sphincter and maintenance of good function. The oncologic outcomes, however, limit the broad application of this approach. This article reviews the recent literature on the role of local excision for rectal cancer and provides insight into its use and limitations.