INTRODUCTION: Although current guidelines recommend distal resection margins (DRM) of 2-5 cm in rectal cancer operation, smaller margins may be safe. We therefore assessed the impact of distal margins on outcomes in patients with rectal cancer treated with neoadjuvant chemoradiotherapy (CRT) followed by radical resection or resection followed by adjuvant CRT. MATERIALS AND METHODS: This study involved 376 patients who underwent sphincter-saving resection for rectal adenocarcinoma and pre- or postoperative CRT between 2000 and 2006. DRMs were measured on pinned fixed specimens. We excluded patients who did not complete planned CRT and those with stage IV disease. A retrospective cross-sectional analysis was performed. RESULTS: No significant differences in local recurrence (9.8 versus 7.3%; P = 0.324) and systemic recurrence (16.4 versus 18.7%; P = 0.731) were observed in patients with DRMs of ≤5 and >5 mm, respectively. Moreover, in each DRM category, there were no differences in local and systemic recurrence rates between patients who received pre- or postoperative CRT. DRM did not affect overall survival (P = 0.880) or 5-year survival rate (80.3 versus76.8%; P = 0.340). CONCLUSION: A distal margin of at least 5 mm with negative resection margin on frozen section does not reduce oncological safety in rectal cancer patients who receive pre- or postoperative CRT.
INTRODUCTION: Although current guidelines recommend distal resection margins (DRM) of 2-5 cm in rectal cancer operation, smaller margins may be safe. We therefore assessed the impact of distal margins on outcomes in patients with rectal cancer treated with neoadjuvant chemoradiotherapy (CRT) followed by radical resection or resection followed by adjuvant CRT. MATERIALS AND METHODS: This study involved 376 patients who underwent sphincter-saving resection for rectal adenocarcinoma and pre- or postoperative CRT between 2000 and 2006. DRMs were measured on pinned fixed specimens. We excluded patients who did not complete planned CRT and those with stage IV disease. A retrospective cross-sectional analysis was performed. RESULTS: No significant differences in local recurrence (9.8 versus 7.3%; P = 0.324) and systemic recurrence (16.4 versus 18.7%; P = 0.731) were observed in patients with DRMs of ≤5 and >5 mm, respectively. Moreover, in each DRM category, there were no differences in local and systemic recurrence rates between patients who received pre- or postoperative CRT. DRM did not affect overall survival (P = 0.880) or 5-year survival rate (80.3 versus76.8%; P = 0.340). CONCLUSION: A distal margin of at least 5 mm with negative resection margin on frozen section does not reduce oncological safety in rectal cancerpatients who receive pre- or postoperative CRT.
Authors: Jose G Guillem; David B Chessin; Alfred M Cohen; Jinru Shia; Madhu Mazumdar; Warren Enker; Philip B Paty; Martin R Weiser; David Klimstra; Leonard Saltz; Bruce D Minsky; W Douglas Wong Journal: Ann Surg Date: 2005-05 Impact factor: 12.969
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Authors: Dong Woo Kang; Han Deok Kwak; Nak Song Sung; In Soo Yang; Se Jin Baek; Jung Myun Kwak; Jin Kim; Seon Hahn Kim Journal: Int J Colorectal Dis Date: 2016-11-29 Impact factor: 2.571
Authors: Jae Woong Han; Min Jae Lee; Ha Kyung Park; Jae Ho Shin; Min Sung An; Tae Kwun Ha; Kwang Hee Kim; Ki Beom Bae; Tae Hyun Kim; Chang Soo Choi; Sang Hoon Oh; Min Kyung Oh; Mi Seon Kang; Kwan Hee Hong Journal: Ann Coloproctol Date: 2013-12-31