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Impact of surgical proximal and distal margins on the recurrence of resectable colon cancer: a single-center observational cohort study

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Abstract

Purpose

Few studies have investigated the impact of the surgical proximal and distal margins on colon cancer recurrence. We conducted this study to investigate the effect of resection margins on the prognosis of resectable colon cancer.

Methods

We analyzed data on 1458 patients who underwent colorectal resection in our institute between January, 2004 and March, 2020, including 579 patients with resectable colon cancer. The association between the resection margin and recurrence for each oncological status was assessed and the value of the resection length that influenced recurrence was analyzed.

Results

Patients who had pT4 colon cancer with margins of more than 7 cm had a trend of fewer recurrences and longer relapse-free survival (RFS) than those with colon cancer of other stages (P = 0.033; hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.20–0.89). Multivariate analysis identified a margin of < 7 cm as an independent risk factor for RFS in patients with pT4 colon cancer (P = 0.023; HR, 2.65; 95% CI 1.013–6.17). No correlation was found between resection margins and recurrence, depending on the extent of lymph node metastasis and tumor location.

Conclusion

A resection margin of at least 7 cm should be maintained for patients with pT4 colon cancer.

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Data availability

The data produced and analyzed in this study are available from the corresponding author upon reasonable request.

Abbreviations

JSCCR:

Japan Society for Cancer of the Colon and Rectum

ESMO:

European Society for Medical Oncology

NCCN:

National Comprehensive Cancer Network

RFS:

Relapse-free survival

CME:

Complete mesocolic excision

HR:

Hazard ratio

CI:

Confidence interval

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Funding

This study did not receive any specific grants from funding agencies in the public, commercial, or non-profit sectors.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka-City, Fukuoka, 812-8582, Japan

    Tetsuro Kawazoe, Satoshi Toyota, Ryota Nakanishi, Hirotada Tajiri, Yoko Zaitsu, Yuichiro Nakashima, Mitsuhiko Ota, Eiji Oki & Tomoharu Yoshizumi

Authors
  1. Tetsuro Kawazoe
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  2. Satoshi Toyota
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  3. Ryota Nakanishi
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  4. Hirotada Tajiri
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  5. Yoko Zaitsu
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  6. Yuichiro Nakashima
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  7. Mitsuhiko Ota
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  8. Eiji Oki
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  9. Tomoharu Yoshizumi
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Contributions

TK and RN designed this study. TK and ST collected the clinical data and performed the statistical analyses. TK, ST, HT, YZ, YN, and MT wrote and edited the manuscript. RN and EO revised the manuscript. TY supervised the study. All the authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Tetsuro Kawazoe.

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Conflict of interest

We have no conflicts of interest to declare.

Ethical approval

This study was conducted in accordance with the principles of the 1964 Declaration of Helsinki and its amendments. This study was approved by the Clinical Research Review Board of Kyushu University.

Consent to participate

Written informed consent was obtained from all participants in the study.

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Kawazoe, T., Toyota, S., Nakanishi, R. et al. Impact of surgical proximal and distal margins on the recurrence of resectable colon cancer: a single-center observational cohort study. Surg Today (2024). https://doi.org/10.1007/s00595-024-02836-8

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