Proposed Distal Margin for Resection of Rectal Cancer
Open Access
- 1 January 1990
- journal article
- Published by Wiley in Japanese Journal of Cancer Research
- Vol. 81 (1), 100-104
- https://doi.org/10.1111/j.1349-7006.1990.tb02513.x
Abstract
To determine the adequate distal margin, particularly from the point of extent of lymph node metastasis, 2,333 lymph nodes from 44 patients with rectal carcinoma were evaluated, using a clearing method. The tumors were divided into two growth patterns; infiltrative and localized. Lymph node metastasis was histo-pathologically examined with special attention focused on nodes on the distal side of the tumor. The intramural spread was also given attention. The proximal pararectal lymph nodes often contained malignant cells, whereas the distal ones were rarely involved, and if involved, they were present within 1 cm from the tumor. Pararectal lymph node metastasis and intramural spread were seen with a range of 1 cm and 0.5 cm, respectively, in the localized type and 1 cm and 2.1 cm, respectively in the infiltrative type. Based on these findings, the distal margin for surgical resection of rectal carcinoma is considered to be 2 cm for the localized type and 3 cm for the infiltrative type.Keywords
This publication has 16 references indexed in Scilit:
- Distal intramural spread of rectal carcinomasDiseases of the Colon & Rectum, 1986
- En Bloc Pelvic Lymphadenectomy and Sphincter Preservation in the Surgical Management of Rectal CancerAnnals of Surgery, 1986
- Facilitating low colorectal anastomosis: Preliminary resultsThe American Journal of Surgery, 1986
- Clearance technique for the detection of lymph nodes in colorectal cancerBritish Journal of Surgery, 1986
- Intramural spread of colon carcinoma: A pathologic studyThe American Journal of Surgery, 1983
- The Relationship Between the Extent of Distal Clearance and Survival and Local Recurrence Rates After Curative Anterior Resection for Carcinoma of the RectumAnnals of Surgery, 1983
- Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: A study of distal intramural spread and of patients' survivalBritish Journal of Surgery, 1983
- Patho-anatomical demonstration of lymph node metastases in a surgical specimenPathology - Research and Practice, 1982
- Extended Resection for Selected Adenocarcinomas of the Large BowelAnnals of Surgery, 1972
- Lymphatic Block with Atypical and Retrograde Lymphatic Metastasis and Spread in Carcinoma of the Colon and RectumAnnals of Surgery, 1966