Factors Determining Circumferential Resection Margin of Rectal Cancer at Maharat Nakhon Ratchasima Hospital
Keywords:
Circumferential resection margin, Rectal cancer, Total mesorectal excisionAbstract
Background: Total mesorectal excision (TME) has recently achieved excellent oncological outcomes for patients with rectal cancer. The TME procedure aims at free circumferential resection margins (CRM), which has been found to be an acceptable surrogate endpoint for loco-regional and disease-free survival.
Objective: To assess factors affecting rates of CRM involvement after rectal cancer excision.
Patients and Methods: The prospective study of 80 rectal carcinoma patients who have definitive operation from January 1, 2009 to July 31, 2010 at Maharat Nakhon Ratchasima Hospital.
Results: Eighty rectal cancer patients (65%) were male with mean age of 62.2 years. The majority of cases (46.3 %) were in stage III disease. In T category, the majority of cases (81.3 %) were in T3 stage and 49% were in N0 stage. The most common location of cancers (40%) was the lower rectum followed by the upper and middle rectum at 30% equally. Univariate analysis of various clinicopathological parameters showed that sex, age > 50 yrs, mucin production, poorly differentiation, presence of neural or lymphovascular invasion, lymph node status, tumor stage III or IV, location of rectal cancer, type of operation, preoperative radiotherapy or even the length of surgeon experience did not influence the CRM involvement. The only factor that significantly affected CRM involvement was T4 category cancer (P = 0.01).
Conclusions: Advanced T stage was found to significantly affect the CRM involvement.
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