What question did this study set out to answer?

Characterize microscopic residual disease patterns and surgical margins using whole-mount histology in locally advanced rectal cancer following preoperative combined modality therapy.

December 19, 2006Annals of SurgeryOpen Access

A Prospective Pathologic Analysis Using Whole-Mount Sections of Rectal Cancer Following Preoperative Combined Modality Therapy

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Authors

JGJosé G. GuillemUniversity of North Carolina at Chapel Hill DCDavid B. ChessinIcahn School of Medicine at Mount Sinai JSJinru ShiaRutgers, The State University of New Jersey

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Implication

Prospective study reveals negative distal margins in rectal cancer after chemoradiation, suggesting a 1-cm margin allows safe sphincter preservation.

Key Points

Characterize microscopic residual disease patterns and surgical margins using whole-mount histology in locally advanced rectal cancer following preoperative combined modality therapy.
Prospective cohort of 109 patients with locally advanced rectal cancer (T2–T4 or N1 staged by endorectal ultrasound) who received preoperative combined modality therapy and total mesorectal excision.
Whole-mount pathologic sections were evaluated for residual tumor extent, circumferential resection margins, distal resection margins, and microscopic intramural spread.
Sphincter-preserving resection was accomplished in 80% of patients (87/109), and distal resection margins were negative in 100% of cases (median 2.1 cm, range 0.4–10 cm).
No positive circumferential margins were observed (median 10 mm, range 1–28 mm), although 6 specimens measured ≤1 mm.
Intramural extension beyond the gross mucosal tumor edge occurred in only 1.8% of patients (2/109, both ≤0.95 cm), with residual disease significantly more frequent in tumors <5 cm from the anal verge (P = 0.03).

Cite This Study

Guillem et al. (2006) studied this question.

synapsesocial.com/papers/6a80f0e6ac2db2fda24d54e2 https://doi.org/10.1097/01.sla.0000232540.82364.43

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Implication

Prospective study reveals negative distal margins in rectal cancer after chemoradiation, suggesting a 1-cm margin allows safe sphincter preservation.

A Prospective Pathologic Analysis Using Whole-Mount Sections of Rectal Cancer Following Preoperative Combined Modality Therapy

Discussion

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Implication

Key Points

Cite This Study

A Prospective Pathologic Analysis Using Whole-Mount Sections of Rectal Cancer Following Preoperative Combined Modality Therapy

Discussion

Member takes

Implication

Key Points

Cite This Study

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