Oncological results in rectal cancer patients with a subcentimetre distal margin after laparoscopic-assisted sphincter-preserving surgery.
Oncological results in rectal cancer patients with a subcentimetre distal margin after laparoscopic-assisted sphincter-preserving surgery.
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腹腔镜辅助保肛手术后远端边缘亚厘米的直肠癌患者的肿瘤学结果。
DOI：
10.1111/ans.17503
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发表时间：
2022-06
影响因子：
1.7
通讯作者：
中科院分区：
文献类型：
--
作者：
Distal resection margin (DRM) is closely associated with sphincter‐preserving surgery and oncological safety for patients with mid‐low rectal cancers. However, the optimal DRM has not been determined. Data of 378 rectal cancer patients who underwent laparoscopic‐assisted sphincter‐preserving surgery from 2009 to 2015 were retrospectively analysed. Patients were divided into two groups based on DRM: ≤1 cm (n = 74) and >1 cm (n = 304). To minimize the differences between the two groups, propensity‐score matching on baseline features was performed. Before propensity‐score matching, no significant differences in 5‐year disease‐free survival (DFS) (92.8% versus 81.3%, P = 0.128) and 5‐year overall survival (OS) (83.7% versus 82.2%, P = 0.892) were observed in patients with DRMs of ≤1 cm (n = 74) and >1 cm (n = 304), respectively. After propensity‐score matching (1:1), there were also no significant differences in DFS (88.1% versus 78.2%, P = 0.162) and OS (84.5% versus 84.9%, P = 0.420) between the DRM of ≤1 cm group (n = 65) and >1 cm group (n = 65), respectively. A total of 44 patients received preoperative chemoradiotherapy (CRT). In this cohort, the 5‐year local recurrence (LR) rates (P = 0.118) and the 5‐year DFS rates (P = 0.298) were not significantly different between the two groups. A total of 334 patients received surgery without neoadjuvant CRT. There were also no significant differences in the 5‐year LR rates (P = 0.150) and 5‐year DFS rates (P = 0.172) between the two groups. When aiming to achieve at least a 1–2 cm distal clinical resection margin, a histological resection margin of <1 cm on the DRM gave equivalent clinical outcomes to a DRM of >1 cm. The optimal distal resection margin (DRM) has been debated in sphincter‐saving surgery for patients with low‐lying rectal cancers. We analysed the impact of a DRM of 1 cm on local recurrence and long‐term survival for patients who underwent sphincter‐preserving surgery. No matter whether patients received neoadjuvant therapy, a DRM of 1 cm may be acceptable.
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影响因子：
168.9
作者：
Martling, AL;Holm, T;Cedermark, B
通讯作者：
Cedermark, B
影响因子：
158.5
作者：
Kapiteijn, E;Marijnen, CAM;van de Velde, CJH
通讯作者：
van de Velde, CJH
影响因子：
45.3
作者：
Stocchi, L;Nelson, H;Beart, R
通讯作者：
Beart, R
影响因子：
9.6
作者：
Shihab, O. C.;Taylor, F.;Brown, G.
通讯作者：
Brown, G.
影响因子：
2.5
作者：
Kim, Young-Wan;Kim, Nam-Kyu;Cho, Chang-Hwan
通讯作者：
Cho, Chang-Hwan