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Article: Surgical lateral clearance in resected rectal carcinomas: A multivariate analysis of clinicopathologic features

TitleSurgical lateral clearance in resected rectal carcinomas: A multivariate analysis of clinicopathologic features
Authors
Issue Date1993
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 1993, v. 71 n. 6, p. 1972-1976 How to Cite?
AbstractBackground. Incomplete removal of the tumor is the main cause of local recurrence in rectal carcinomas; this often occurs at the lateral aspects devoid of the peritoneum. The authors examined prospectively 80 resected rectal carcinoma specimens in an attempt to discover a reliable method to detect lateral resection margin (LRM) involvement by these tumors and to identify pathologic factors that would be prognostically important. Methods. In each of the 80 resected specimens, the whole tumor was embedded, and whole-mount sections of the entire tumor and the surrounding mesorectum were examined after serial transverse slicing. The distance from the outermost part of the tumor to the LRM (surgical clearance) was measured. Results. Six (7.5%) of the 80 specimens showed LRM involvement (defined as surgical clearance ≤ 1 mm) in the single slice seen macroscopically to have the deepest tumor invasion, whereas 16 specimens (20%) were found to have LRM involved after examining all slices microscopically. Surgical clearance had a strong inverse relationship with Dukes staging (P < 0.001) and depth of tumor invasion (P = 0.001). The overall local recurrence rate was 28%; it was much higher (53%) in the patients who had LRM involved by tumor. As a whole, local recurrence was related significantly to LRM involvement (P = 0.006). Survival rates were correlated with macroscopic (n = 3) and microscopic (n = 13) features of the resected specimens using Cox multivariate regression analysis. Three of the nine pathologic parameters isolated (i.e., surgical clearance, cellular differentiation, and number of involved pericolic lymph nodes) were identified as favorable independent prognostic factors. Conclusions. Local recurrence is related closely to LRM involvement. Embedding and examining the entire tumor and mesorectum is the only reliable and satisfactory means of assessing LRM. Detailed pathologic study on the resected tumor is important when assessing the prognosis.
Persistent Identifierhttp://hdl.handle.net/10722/147972
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, IOLen_US
dc.contributor.authorLuk, ISCen_US
dc.contributor.authorYuen, STen_US
dc.contributor.authorLau, PWKen_US
dc.contributor.authorPritchett, CJen_US
dc.contributor.authorNg, Men_US
dc.contributor.authorPoon, GPen_US
dc.contributor.authorHo, Jen_US
dc.date.accessioned2012-05-29T06:10:10Z-
dc.date.available2012-05-29T06:10:10Z-
dc.date.issued1993en_US
dc.identifier.citationCancer, 1993, v. 71 n. 6, p. 1972-1976en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/147972-
dc.description.abstractBackground. Incomplete removal of the tumor is the main cause of local recurrence in rectal carcinomas; this often occurs at the lateral aspects devoid of the peritoneum. The authors examined prospectively 80 resected rectal carcinoma specimens in an attempt to discover a reliable method to detect lateral resection margin (LRM) involvement by these tumors and to identify pathologic factors that would be prognostically important. Methods. In each of the 80 resected specimens, the whole tumor was embedded, and whole-mount sections of the entire tumor and the surrounding mesorectum were examined after serial transverse slicing. The distance from the outermost part of the tumor to the LRM (surgical clearance) was measured. Results. Six (7.5%) of the 80 specimens showed LRM involvement (defined as surgical clearance ≤ 1 mm) in the single slice seen macroscopically to have the deepest tumor invasion, whereas 16 specimens (20%) were found to have LRM involved after examining all slices microscopically. Surgical clearance had a strong inverse relationship with Dukes staging (P < 0.001) and depth of tumor invasion (P = 0.001). The overall local recurrence rate was 28%; it was much higher (53%) in the patients who had LRM involved by tumor. As a whole, local recurrence was related significantly to LRM involvement (P = 0.006). Survival rates were correlated with macroscopic (n = 3) and microscopic (n = 13) features of the resected specimens using Cox multivariate regression analysis. Three of the nine pathologic parameters isolated (i.e., surgical clearance, cellular differentiation, and number of involved pericolic lymph nodes) were identified as favorable independent prognostic factors. Conclusions. Local recurrence is related closely to LRM involvement. Embedding and examining the entire tumor and mesorectum is the only reliable and satisfactory means of assessing LRM. Detailed pathologic study on the resected tumor is important when assessing the prognosis.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_US
dc.relation.ispartofCanceren_US
dc.subject.meshAdenocarcinoma - Mortality - Pathology - Surgeryen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshNeoplasm Recurrence, Localen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRectal Neoplasms - Mortality - Pathology - Surgeryen_US
dc.subject.meshSurvival Rateen_US
dc.titleSurgical lateral clearance in resected rectal carcinomas: A multivariate analysis of clinicopathologic featuresen_US
dc.typeArticleen_US
dc.identifier.emailNg, IOL:iolng@hkucc.hku.hken_US
dc.identifier.authorityNg, IOL=rp00335en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8443747-
dc.identifier.scopuseid_2-s2.0-0027400937en_US
dc.identifier.volume71en_US
dc.identifier.issue6en_US
dc.identifier.spage1972en_US
dc.identifier.epage1976en_US
dc.identifier.isiWOS:A1993KQ38100007-
dc.publisher.placeUnited Statesen_US

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