V S R Rao1, M M Y Yeung, J Cooke, E Salim, P K Jain. 1. Department of Upper GI Surgery, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, UK. sumaraman@googlemail.com
Abstract
BACKGROUND: Circumferential resection margin (CRM) is widely recognized as an important prognostic factor in esophageal cancer. The aim of this study was to evaluate the clinical significance of CRM according to the current criteria of the Royal College of Pathologists (RCP) and the College of American Pathologists (CAP). METHODS: Patients (115) who underwent esophagectomy between 2000 and 2006 were included in this retrospective study. Factors such as neo-adjuvant therapy, site, histological type, size, and lymph node involvement were tested to determine predictability of CRM involvement. Along with these, age, sex, CRM, and adjuvant therapy were analyzed to determine influence on survival. RESULTS: On the basis of CRM, patients were divided into three groups (involved, 0.1-1 mm and >1mm). Size (T) was the only factor strongly predictive of CRM involvement (P < 0.001). Size (T; P = 0.04) and lymph node involvement (N; P = 0.0003) were found to significantly influence overall survival (OS). When patients with CRM (involved and 0.1-1mm) were compared with those with CRM > 1 mm, OS was significantly prolonged in the latter (P = 0.02). CONCLUSION: This study appears to lend credence to the RCP criteria for definition of CRM over the CAP criteria.
BACKGROUND: Circumferential resection margin (CRM) is widely recognized as an important prognostic factor in esophageal cancer. The aim of this study was to evaluate the clinical significance of CRM according to the current criteria of the Royal College of Pathologists (RCP) and the College of American Pathologists (CAP). METHODS:Patients (115) who underwent esophagectomy between 2000 and 2006 were included in this retrospective study. Factors such as neo-adjuvant therapy, site, histological type, size, and lymph node involvement were tested to determine predictability of CRM involvement. Along with these, age, sex, CRM, and adjuvant therapy were analyzed to determine influence on survival. RESULTS: On the basis of CRM, patients were divided into three groups (involved, 0.1-1 mm and >1mm). Size (T) was the only factor strongly predictive of CRM involvement (P < 0.001). Size (T; P = 0.04) and lymph node involvement (N; P = 0.0003) were found to significantly influence overall survival (OS). When patients with CRM (involved and 0.1-1mm) were compared with those with CRM > 1 mm, OS was significantly prolonged in the latter (P = 0.02). CONCLUSION: This study appears to lend credence to the RCP criteria for definition of CRM over the CAP criteria.
Authors: William H Allum; Luigi Bonavina; Stephen D Cassivi; Miguel A Cuesta; Zhao Ming Dong; Valter Nilton Felix; Edgar Figueredo; Piers A C Gatenby; Leonie Haverkamp; Maksat A Ibraev; Mark J Krasna; René Lambert; Rupert Langer; Michael P N Lewis; Katie S Nason; Kevin Parry; Shaun R Preston; Jelle P Ruurda; Lara W Schaheen; Roger P Tatum; Igor N Turkin; Sylvia van der Horst; Donald L van der Peet; Peter C van der Sluis; Richard van Hillegersberg; Justin C R Wormald; Peter C Wu; Barbara M Zonderhuis Journal: Ann N Y Acad Sci Date: 2014-09 Impact factor: 5.691
Authors: J B Hulshoff; Z Faiz; A Karrenbeld; G Kats-Ugurlu; J G M Burgerhof; J K Smit; J Th M Plukker Journal: Ann Surg Oncol Date: 2015-08-28 Impact factor: 5.344
Authors: W R C Knight; J Zylstra; W Wulaningsih; M Van Hemelrijck; D Landau; N Maisey; A Gaya; C R Baker; J A Gossage; J Largergren; A R Davies Journal: BJS Open Date: 2018-04-23