Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy Journal Article

  

Authors:	Moore, H. G.; Riedel, E.; Minsky, B. D.; Saltz, L.; Paty, P.; Wong, D.; Cohen, A. M.; Guillem, J. G.
Article Title:	Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy
Abstract:	BACKGROUND: Preoperative combined-modality therapy (CMT) for rectal cancer allows a sphincter-sparing procedure in some individuals who would otherwise require an abdominoperineal resection. To further define the subset of rectal cancer patients suitable for this approach, we determined the adequacy of a distal margin of < or = 1 cm in patients with locally advanced rectal cancer requiring preoperative CMT. METHODS: Ninety-four consecutive patients, status post curative low anterior resection for rectal cancer after preoperative CMT, were identified from the prospective Colorectal Service Database. Distal margin length, tumor grade, tumor-node-metastasis stage, presence of lymphovascular and perineural invasion, and tumor distance from the anal verge were examined for their effect on recurrence and survival. Median follow-up was 44 months. RESULTS: Distal margin length ranged from.1 to 9.5 cm (median, 2.0 cm) and did not correlate with local recurrence (hazard ratio, 1.1; P =.34) or recurrence-free survival (hazard ratio, 1.1; P =.29) by univariate analysis. Kaplan-Meier estimates of recurrence-free survival and local recurrence at 3 years for the < or = 1 cm versus >1 cm and the < ore = 2 cm versus > 2 cm groups were not significantly different. Groups were well matched for other clinicopathologic variables. CONCLUSIONS: Our data suggest that for patients with locally advanced rectal cancer undergoing resection and preoperative CMT, distal margins < or = 1 cm do not seem to compromise oncological outcome.
Keywords:	adult; aged; disease-free survival; middle aged; mortality; multimodality cancer therapy; disease free survival; preoperative care; combined modality therapy; cancer staging; follow up; methodology; follow-up studies; neoplasm staging; neoplasm recurrence, local; pathology; tumor recurrence; abdominal surgery; rectal neoplasms; rectum tumor; digestive system surgical procedures; life tables; humans; human; male; female; article; life table
Journal Title:	Annals of Surgical Oncology
Volume:	10
Issue:	1
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2003-01-01
Start Page:	80
End Page:	85
Language:	English
PUBMED:	12513965
PROVIDER:	scopus
DOI:	10.1245/ASO.2003.04.010
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-0037267010&partnerID=40&md5=6fe404ae436c76a6fbff7cc778a1ac4e
Notes:	Export Date: 12 September 2014 -- Source: Scopus

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