Byung Mo Kang1, Yong-Koo Park2, Sun Jin Park3, Kil Yeon Lee3, Chang Woo Kim4, Suk-Hwan Lee5. 1. Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea. 2. Department of Pathology, Kyung Hee Medical Center, Kyung Hee University School of Medicine, Seoul, South Korea. 3. Department of Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine, Seoul, South Korea. 4. Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea. 5. Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea. Electronic address: leeshdr@khu.ac.kr.
Abstract
BACKGROUND/ OBJECTIVE: The purpose of this study was to assess the impact of circumferential tumor location on circumferential resection margin (CRM) status and the depth of tumor invasion in mid and low rectal cancer. METHODS: We retrospectively analyzed whole-mount slides of 58 patients who underwent total mesorectal excision for mid and low rectal cancer. The rate of tumor-positive CRM was compared according to the circumferential tumor location. In 31 patients, morphometric analyses of whole-mount specimens were performed to measure the depth of tumor invasion according to circumferential tumor location. RESULTS: Among 58 patients, 50% of tumors were anterior tumor and 50% were nonanterior. A tumor-positive CRM was more observed frequently in anterior tumors than in nonanterior tumors (41.1% vs. 10.3%, p = 0.007). In a multivariate analysis, anterior tumor was the only independent risk factor for a positive CRM (odds ratio 4.725, 95% confidence interval 1.102-20.261, p = 0.037). In a morphometric analysis of 31 patients, the depth of tumor invasion from the muscularis mucosa was greater (11.9 mm vs. 6.6 mm, p = 0.028) in those with anterior tumors. CONCLUSION: Anterior tumors are associated with a higher risk of tumor-positive CRM and tend to exhibit deeper invasion in mid and low rectal cancer.
BACKGROUND/ OBJECTIVE: The purpose of this study was to assess the impact of circumferential tumor location on circumferential resection margin (CRM) status and the depth of tumor invasion in mid and low rectal cancer. METHODS: We retrospectively analyzed whole-mount slides of 58 patients who underwent total mesorectal excision for mid and low rectal cancer. The rate of tumor-positive CRM was compared according to the circumferential tumor location. In 31 patients, morphometric analyses of whole-mount specimens were performed to measure the depth of tumor invasion according to circumferential tumor location. RESULTS: Among 58 patients, 50% of tumors were anterior tumor and 50% were nonanterior. A tumor-positive CRM was more observed frequently in anterior tumors than in nonanterior tumors (41.1% vs. 10.3%, p = 0.007). In a multivariate analysis, anterior tumor was the only independent risk factor for a positive CRM (odds ratio 4.725, 95% confidence interval 1.102-20.261, p = 0.037). In a morphometric analysis of 31 patients, the depth of tumor invasion from the muscularis mucosa was greater (11.9 mm vs. 6.6 mm, p = 0.028) in those with anterior tumors. CONCLUSION:Anterior tumors are associated with a higher risk of tumor-positive CRM and tend to exhibit deeper invasion in mid and low rectal cancer.
Authors: Hyeong-Min Park; Ook Song; Jaram Lee; Soo Young Lee; Chang Hyun Kim; Hyeong Rok Kim Journal: Ann Surg Treat Res Date: 2022-08-05 Impact factor: 1.766