Circumferential Resection Margin Involvement in Stage III Rectal Cancer Patients Treated with Curative Resection Followed by Chemoradiotherapy: A Surrogate Marker for Local Recurrence?.
10.3349/ymj.2013.54.1.131
- Author:
Jeonghyun KANG
1
;
Hyunki KIM
;
Hyuk HUR
;
Byung Soh MIN
;
Seung Hyuk BAIK
;
Kang Young LEE
;
Seung Kook SOHN
;
Nam Kyu KIM
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. namkyuk@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Rectal neoplasm;
circumferential resection margin;
local recurrence;
systemic metastasis;
prognosis
- MeSH:
Aged;
Biological Markers;
Chemoradiotherapy/*methods;
Female;
Fluorodeoxyglucose F18/pharmacology;
Follow-Up Studies;
Humans;
Lymphatic Metastasis;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Neoplasm Metastasis;
Neoplasm Recurrence, Local;
Neoplasm Staging;
Positron-Emission Tomography;
Prognosis;
Rectal Neoplasms/diagnosis/*surgery/*therapy;
Recurrence;
Surgical Procedures, Operative;
Tomography, X-Ray Computed;
Treatment Outcome
- From:Yonsei Medical Journal
2013;54(1):131-138
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Circumferential resection margin (CRM) involvement is a well-known predictor for poor prognosis in rectal cancer. However, the significance is controversial in some studies. Accordingly, this study attempted to examine the prognostic impact of CRM involvement in stage III rectal cancer. MATERIALS AND METHODS: Between January 1990 and December 2007, a total of 449 patients who underwent curative resection followed by complete adjuvant chemoradiotherapy for stage III rectal cancer located within 12 cm from the anal verge were selected. Patients were divided into a CRM-positive group (n=79, 17.6%) and a CRM-negative group (n=370, 82.4%). RESULTS: With a median follow-up of 56.6 months, recurrent disease was seen in 53.2 and 43.5% of the CRM-positive and CRM-negative group, respectively. CRM involvement was an independent prognostic factor for 5-year systemic recurrence-free survival (HR: 1.5, CI: 1.0-2.2, p=0.017). However, no significant difference was observed for local recurrence rate between the two groups (13.0 and 13.5%, respectively, p=0.677). CONCLUSION: In this study, local recurrence rate did not differ according to CRM involvement status in stage III rectal cancer patients, although CRM involvement was shown to be an independent poor prognostic factor. Accordingly, validation of the results of this study by further large prospective randomized trials is warranted.
