Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma - Not one millimeter but two millimeters is the limit
Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma - Not one millimeter but two millimeters is the limit
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DOI：
10.1097/00000478-200203000-00009
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发表时间：
2002-03-01
影响因子：
5.6
通讯作者：
van Krieken, JHJM
中科院分区：
文献类型：
--
作者：
Nagtegaal, ID;Marijnen, CAA;van Krieken, JHJM
尽管直肠癌的手术治疗策略有所改进，但仍有5-15%的患者会出现局部复发。保守手术后，是否累及环切缘（CRM）是局部复发的重要预测因素。全肠系膜切除（TME）后CRM阳性的后果尚未在大量患者群体中进行评估。在一项全国范围内的随机多中心试验中，比较术前放疗联合TME与单独TME治疗直肠癌，根据试验方案确定CRM是否参与。在本研究中，我们分析了评估CRM以预测未放疗患者局部复发的标准（n = 656，中位随访35个月）。CRM参与是TME后局部复发的有力预测因子。小于或等于2mm的切缘与16%的局部复发风险相关，而在肿瘤周围有更多肠系膜组织的患者中，这一风险为5.8%
Despite improved surgical treatment strategies for rectal cancer, 5-15% of all patients will develop local recurrences. After conservative surgery, circumferential resection margin (CRM) involvement is a strong predictor of local recurrence. The consequences of a positive CRM after total mesorectal excision (TME) have not been evaluated in a large patient population. In a nationwide randomized multicenter trial comparing preoperative radiotherapy and TME versus TME alone for rectal cancer, CRM involvement was determined according to trial protocol. In this study we analyze the criteria by which the CRM needs to be assessed to predict local recurrence for nonirradiated patients (n = 656, median follow-up 35 months). CRM involvement is a strong predictor for local recurrence after TME. A margin of less than or equal to2 mm is associated with a local recurrence risk of 16% compared with 5.8% in patients with more mesorectal tissue surrounding the tumor (p