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Prognostic Impact of Circumferential Resection Margin in Rectal Cancer Treated with Preoperative Chemoradiotherapy

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The circumferential resection margin (CRM) is a strong prognostic factor in rectal cancer. The purpose of this study was to investigate the relationship between CRM distance and recurrence in patients with locally advanced rectal cancer who received preoperative chemoradiotherapy (CRT).

Methods

We analyzed data for 561 patients who underwent preoperative CRT and curative surgery for locally advanced rectal cancer between August 2001 and December 2008. CRM was divided into four groups: group 1, CRM > 2 mm; group 2, 1.1–2.0 mm; group 3, 0.1–1.0 mm; and group 4, 0 mm. We assessed the associations of CRM with local recurrence and disease-free survival.

Results

Groups 1, 2, 3, and 4 comprised 487, 36, 20, and 18 patients, respectively. The local recurrence rate was highest and the disease-free survival rate was lowest in group 4, followed by groups 3, 2, and 1. Survival was similar between groups 2 and 1. Local recurrence rates were lower in groups 3, 2, and 1 than in group 4 [hazard ratio (HR) 0.28, 95 % confidence interval (CI) 0.09–0.91, P = 0.035; HR 0.11, 95 % CI 0.03–0.46, P = 0.002; HR 0.18, 95 % CI 0.08–0.42, P < 0.0001, respectively]. Disease-free survival rates were higher in groups 3, 2, and 1 than in group 4 (HR 0.32, 95 % CI 0.13–0.75, P = 0.009; HR 0.24, 95 % CI 0.10–0.54, P = 0.001; HR 0.26, 95 % CI 0.14–0.48, P < 0.0001, respectively).

Conclusions

After preoperative CRT, CRM distance provides useful information for risk stratification in the recurrence of rectal cancer.

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Acknowledgment

This study was supported by a grant from the National Cancer Center of Korea (NCC-0910160) and by the Converging Research Center Program funded by the Ministry of Education, Science and Technology (project 1131150).

Conflict of interest

The authors indicated no potential conflicts of interest.

Author information

Author notes

  1. Ji Won Park MD

    Present address: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

Authors and Affiliations

  1. Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea

    Mi Ri Hwang MD, Ji Won Park MD, Dae Yong Kim MD, Hee Jin Chang MD, Sun Young Kim MD, Sung Chan Park MD, Hyo Seong Choi MD & Jae Hwan Oh MD

  2. Department of Epidemiology and Heath Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea

    Sohee Park PhD

  3. Cancer Biostatistics Branch, Research Institute, National Cancer Center, Goyang, Korea

    Hyekyoung Yoon MS

  4. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Seung-Yong Jeong MD

  5. Cancer Research Institute, Seoul National University, Seoul, Korea

    Ji Won Park MD & Seung-Yong Jeong MD

  6. Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, Korea

    Ji Won Park MD & Seung-Yong Jeong MD

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  1. Mi Ri Hwang MD
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Correspondence to Ji Won Park MD.

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Hwang, M.R., Park, J.W., Park, S. et al. Prognostic Impact of Circumferential Resection Margin in Rectal Cancer Treated with Preoperative Chemoradiotherapy. Ann Surg Oncol 21, 1345–1351 (2014). https://doi.org/10.1245/s10434-014-3484-1

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  • DOI: https://doi.org/10.1245/s10434-014-3484-1

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