Prognostic Significance of Circumferential Resection Margin Following Total Mesorectal Excision and Adjuvant Chemoradiotherapy in Patients with Rectal Cancer
- 10 November 2006
- journal article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 14 (2), 462-469
- https://doi.org/10.1245/s10434-006-9171-0
Abstract
This study was designed to evaluate the prognostic value of circumferential resection margin (CRM) in rectal cancer patients who underwent curative resection with adjuvant chemoradiotherapy (CRT). We studied 504 patients who underwent total mesorectal excision with adjuvant CRT for rectal cancer between 1997 and 2001. The patients were divided into two groups: a negative CRM group (CRM > 1 mm) and a positive CRM group (CRM ≤ 1 mm). The survival rates, local recurrence rates, and systemic recurrence rates were compared between groups. The negative CRM group had 460 patients and the positive CRM group had 44 patients. The 5-year local and systemic recurrence rates were 11.3 and 25.3%, respectively, in the negative CRM group and 35.2 and 60.8% in the positive CRM group, respectively. The cancer-specific 5-year survival rates for the two groups were 72.5 and 26.9% (P < .001), respectively. CRM was found to be an independent prognostic factor by multivariate analyses which were adjusted for known outcome predictors (P < .001). Oncological outcome for patients in the positive CRM group is less favorable than for those in the negative CRM group. Adjuvant CRT is not a definite treatment modality that can be used to compensate for a positive CRM following TME and adjuvant CRT in patients with TNM stage II or III rectal cancer.Keywords
This publication has 25 references indexed in Scilit:
- Combined modality treatment for rectal cancerSeminars in Oncology, 2005
- The circumferential margin in rectal cancerEuropean Journal Of Cancer, 2002
- Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancerBritish Journal of Surgery, 2002
- Rectal CancerArchives of Surgery, 1998
- Rate and treatment of pelvic recurrence after abdominoperineal resection and low anterior resection for rectal cancerDiseases of the Colon & Rectum, 1995
- Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancerThe Lancet, 1990
- LOCAL RECURRENCE OF RECTAL ADENOCARCINOMA DUE TO INADEQUATE SURGICAL RESECTIONThe Lancet, 1986
- RECURRENCE AND SURVIVAL AFTER TOTAL MESORECTAL EXCISION FOR RECTAL CANCERThe Lancet, 1986
- Patterns of pelvic recurrence following definitive resections of rectal cancerCancer, 1984
- The mesorectum in rectal cancer surgery—the clue to pelvic recurrence?British Journal of Surgery, 1982