Is a Short Distal Resection Margin of Less than One Centimeter in a Sphincter-saving Resection for Rectal Cancer Oncologically Safe?.
10.3393/jksc.2007.23.6.454
- Author:
Min Jeong CHO
1
;
Chang Sik YU
;
In Ja PARK
;
Sang Hoon JEONG
;
Pheung Ha CHAE
;
Dong Heun HONG
;
Dea Dong KIM
;
Hee Cheol KIM
;
Jin Cheon KIM
Author Information
1. Colorectal Clinic, Asan Medical Center and Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea. csyu@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Rectal cancer;
Distal margin;
Local recurrence
- MeSH:
Chemoradiotherapy, Adjuvant;
Follow-Up Studies;
Humans;
Liver;
Lung;
Rectal Neoplasms*;
Recurrence
- From:Journal of the Korean Society of Coloproctology
2007;23(6):454-459
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Sphincter preservation is one of the main goals in the treatment of rectal cancer. The aim of this study was to evaluate the oncologic safety of a sphincter-saving resection with a distal resection margin of less than 1 cm. METHODS: Two hundred forty-eight patients who underwent a sphincter-saving resection between June 1989 and December 2002 and who had a confirmed distal resection margin of less than 1 cm on pathologic examination were included. All patients were evaluated for local and systemic recurrences. RESULTS: The median follow-up period was 45 (6~144) months. The mean length of distal resection margin was 0.79+/-0.26 cm. Lower rectalcancer was most common (56.5%). Forty patients (16.1%) experienced recurrence. The local recurrence rate was 3.6%, systemic recurrence rate was 11.7%, and the combined local and systemic recurrence rate was 0.4%. In systemic recurrence, the liver was the most common site, followed by the lung. Among stage II & III groups, patients who underwent adjuvant chemoradiotherapy experienced significantly lower local recurrence compared to patients in the chemotherapy-only or the no-adjuvant group (2.6%, 12.9%, 8.7%, P=0.05). The length of distal resection margin, the total mesorectal excision, the location of tumor, sex, histology, and stage were not associated with local recurrence. CONCLUSIONS: A distal resection margin of less than 1 cm in a sphincter-saving resection showed acceptableoncologic outcomes. Adjuvant chemoradiotherapy were beneficial to reduce local recurrence in the stage II and the stage III groups.
