This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Rectum, Subject name: Surgery
Local excision in CA rectum is done in all, except: 
Select and explain. 
A. Within 6 cm of anal verge, B. Lesion <4 cm, C. Involvement of <40% circumference, D. T1 and T2 cancer with or without lymph node involvement
D: T1 and T2 cancer with or without lymph node involvement
Answer: D: T1 and T2 cancer with or without lymph node involvement 
Explanation: Ans. (d) T1 and T2 cancer with or without lymph node involvementRef: Sabiston 19th Edition, Pages 1356-1360Transanal excision of cancer rectum* T1N0 or T2N0 lesion <4cm in diameter* <40% circumference of the lumen* <10cm from dentate line* Well to moderately differentiated histology* No evidence of lymphatic or vascular invasion on biopsyOn Endo USG:* T1 and T2 lesions without nodes will be opted for Transanal excision