Factors Influencing Circumferential Resection Margin in Rectal Cancer.
Summary of "Factors Influencing Circumferential Resection Margin in Rectal Cancer."
Aim:â€‚ Abdominoperineal resection (APR) has been associated with higher circumferential resection margin (CRM) involvement and local recurrence rates than extralevator APR for low rectal cancer. This study aimed to evaluate CRM in APR and low anterior resection (LAR) specimens and to identify factors influencing CRM involvement. Method:â€‚ All pathological specimens from consecutive patients with rectal cancer who underwent curative resection at Cleveland Clinic Florida from 01/2000 to 07/2010 were reviewed by two pathologists. Demographics, tumour characteristics, operative data, postoperative pathology, and Dworak's tumour regression grade were compared between specimens with positive and negative CRM. Results:â€‚ 154 patients underwent curative APR (n=65) or LAR (n=69). Mean tumour size was 3.6 cm, and mean distance from the dentate line was 5.4 cm. Nine (6.8%) patients had a positive CRM (n=6 APR, 3=LAR), which was associated with tumour size > 5.9 cm (p = 0.002),â€ƒâ‰¤â€ƒ2.6 cm distance from the dentate line (p = 0.013), microvascular invasion (p = 0.009), perineural invasion (p < 0.001), number of positive lymph nodes (p = 0.046), and incomplete total mesorectal excision (TME) (p < 0.001). APR specimens were three times more likely than LAR specimens to have an incomplete mesorectum (9.8%vs 2.9%, p = 0.322). Conclusions:â€‚ Factors associated with positive CRM were tumour size > 5.9 cm, <â€ƒ2.6 cm distance from the dentate line, incomplete TME, number of positive nodes, and microvascular and perineural invasion. The incidence of a positive CRM did not significantly differ between LAR and APR (3 LAR, 6 APR). Â© 2012 The Authors Colorectal Disease Â© 2012 The Association of Coloproctology of Great Britain and Ireland.
Cleveland Clinic Florida, Weston, USA James Cook University, Townsville, Queensland, Australia.
This article was published in the following journal.
Name: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22776435
- DOI: http://dx.doi.org/10.1111/j.1463-1318.2012.03179.x
Medical and Biotech [MESH] Definitions
Confounding Factors (epidemiology)
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.
Tumors or cancer of the RECTUM.
A cancer registry mandated under the National Cancer Act of 1971 to operate and maintain a population-based cancer reporting system, reporting periodically estimates of cancer incidence and mortality in the United States. The Surveillance, Epidemiology, and End Results (SEER) Program is a continuing project of the National Cancer Institute of the National Institutes of Health. Among its goals, in addition to assembling and reporting cancer statistics, are the monitoring of annual cancer incident trends and the promoting of studies designed to identify factors amenable to cancer control interventions. (From National Cancer Institute, NIH Publication No. 91-3074, October 1990)
Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI.
Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin.
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