+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comparison of circumferential margin involvement between restorative and nonrestorative resections for rectal cancer

Comparison of circumferential margin involvement between restorative and nonrestorative resections for rectal cancer

Colorectal Disease 7(4): 369-374

To study circumferential margin involvement (CMI) in patients undergoing restorative, compared with nonrestorative, surgery for rectal cancer. Descriptive multicentre study, using routinely collected clinical data from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) Bowel Cancer Audit database. The study encompassed 1403 newly diagnosed patients with rectal cancer undergoing either restorative (anterior resection (AR)), or nonrestorative (abdominoperineal excision of rectum (APER) or Hartmann's procedure), surgery. Operations were carried out in 39 hospitals during a variable period between April 1999 to March 2002. A logistic regression analysis was used to control for variables associated with circumferential margin involvement. One thousand and thirty-six patients satisfied the inclusion criteria. The average CMI was 12.5% (range 0-33.3% between hospitals). CMI for anterior resection was 7.5% (n = 629) compared with a CMI of 16.7% for APER (n = 306) and a CMI of 31.7% for Hartmann's procedure (n = 101); P < or = 0.001. CMI for patients undergoing curative surgery was 7.1% (423 anterior resections, CMI 3.8% (n = 16); 181 APER, CMI 13.3% (n = 24); 29 Hartmann's procedure, CMI 17.2%). On multivariate analysis, having controlled for Dukes' stage and operative intent, the CMI was significantly different between APER and AR (odds ratio 3.3, 95%CI 2.0-5.4), but less so between Hartmann's procedure and AR (odds ratio 2.2, 95%CI 1.1-4.2). APER is associated with a significantly higher CMI than anterior resection. Attention to surgical technique, with a wide perineal dissection and the use of pre-operative adjuvant therapy, may reduce CMI in patients undergoing APER.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 048602113

Download citation: RISBibTeXText

PMID: 15932561

DOI: 10.1111/j.1463-1318.2005.00767.x

Related references

Rectal cancers with microscopic circumferential resection margin involvement (R1 resections): Survivals, patterns of recurrence, and prognostic factors. Journal of Surgical Oncology 114(5): 642-648, 2016

Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet (North American Edition) 344(8924): 707-711, 1994

MRI criterion for prediction of involvement of circumferential resection margin in rectal cancer. Indian Journal of Radiology and Imaging 21(1): 69-70, 2011

Comparison of CT and MRI in the pre-operative staging of rectal adenocarcinoma and prediction of circumferential resection margin involvement by MRI. Colorectal Disease 5(5): 396-401, 2003

Circumferential resection margin involvement after laparoscopic abdominoperineal excision for rectal cancer. Colorectal Disease 14(4): 431-437, 2012

The Prognostic Value of Circumferential Resection Margin Involvement in Patients with Extraperitoneal Rectal Cancer. American Surgeon 82(4): 348-355, 2016

Pathologic study of circumferential margin involvement in middle and lower rectal cancer. Zhonghua Wai Ke Za Zhi 47(22): 1689-1692, 2009

Factors affecting circumferential resection margin involvement after rectal cancer excision. Diseases of the Colon and Rectum 50(1): 29-36, 2007

Occurrence and prognostic value of circumferential resection margin involvement for patients with rectal cancer. International Journal of Colorectal Disease 24(4): 385-390, 2009

Risk factors of circumferential resection margin involvement in the patients with extraperitoneal rectal cancer. Journal of the Korean Surgical Society 82(3): 165-171, 2012

Mesorectal spread and circumferential margin involvement of rectal cancer studied on large slice. Sichuan Da Xue Xue Bao. Yi Xue Ban 35(5): 723-726, 2004

Prognostic value of circumferential resection margin involvement in patients with locally-advanced rectal cancer. Cirugia Espanola 81(1): 18-22, 2007

Variations in pelvic dimensions do not predict the risk of circumferential resection margin (CRM) involvement in rectal cancer. World Journal of Surgery 31(6): 1313-1320, 2007

Predictors of circumferential resection margin involvement in surgically resected rectal cancer: A retrospective review of 23,464 patients in the US National Cancer Database. International Journal of Surgery 28: 112-117, 2016

Accuracy of high-resolution MRI with lumen distention in rectal cancer staging and circumferential margin involvement prediction. Korean Journal of Radiology 15(1): 37-44, 2014