Effect of the distance of the circumferential resection margin on postoperative recurrence after laparoscopic radical resection of colon cancer
10.3760/cma.j.cn115455-20230223-00173
- VernacularTitle:腹腔镜下结肠癌根治术后环周切缘距离对术后复发的影响
- Author:
Zuoyu LI
1
;
Yuandong ZHU
;
Haiyuan LIU
;
Chengdong LU
;
Zhengming SONG
Author Information
1. 义乌市中心医院肛肠外科，义乌 322000
- Keywords:
Colonic neoplasms;
Laparoscopic radical resection of colon cancer;
Circumferential resection margin;
Recurrence
- From:
Chinese Journal of Postgraduates of Medicine
2023;46(10):885-889
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of the distance of the circumferential resection margin (CRM) on postoperative recurrence after laparoscopic radical resection of colon cancer.Methods:The clinical data of 83 patients who underwent laparoscopic radical resection of colon cancer in Yiwu Central Hospital from January 2020 to January 2022 were retrospectively included. They were divided into recurrent group (16 cases) and non-recurrent group (67 cases) according to the recurrence within 1 year after operation. The clinical data, postoperative CRM distance and laboratory indicators of the two groups were collected to analyze the influence of CRM distance on postoperative recurrence after laparoscopic radical resection of colon cancer.Results:The proportion of patients treated with postoperative chemotherapy, and postoperative CRM distance in the recurrent group were lower than those in the non-recurrent group: 9/16 vs. 83.58 % (56/67), (0.85 ± 0.23) mm vs. (1.64 ± 0.76) mm. The levels of CEA and CA19-9 at admission were higher than those in the non-recurrent group: (156.74 ± 11.58) μg/L vs. (149.96 ± 10.26) μg/L, (15.63 ± 2.77) kU/L vs. (14.04 ± 2.35) kU/L, and the differences were statistically significant ( P<0.05). Point binary correlation analysis showed that there was a negative correlation between CRM distance and postoperative recurrence after laparoscopic radical resection of colon cancer ( r = - 0.412, P<0.01). Multivariate Logistic regression analysis showed that the long distance of CRM was the protective factor of recurrence after laparoscopic radical resection of colon cancer ( OR<1, P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the CRM distance to predict the recurrence after laparoscopic radical resection of colon cancer was 0.833>0.7, and the predictive value was good. When the optimal threshold was 1.080 mm, the ideal sensitivity and specificity could be obtained 87.50% and 81.00%. Conclusions:The shorter the CRM distance after laparoscopic radical resection of colon cancer, the higher the risk of recurrence. The CRM distance can be used as a predictor of recurrence after laparoscopic radical resection of colon cancer.
