Circumferential resection margin as a prognostic factor after rectal cancer surgery: A large population-based retrospective study.
Circumferential resection margin as a prognostic factor after rectal cancer surgery: A large population-based retrospective study.
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作者：
Liu Q;Luo D;Cai S;Li Q;Li X
本研究旨在研究环周切除切缘（CRM）作为直肠癌手术后长期肿瘤生存的预后因素。本研究确定了2010年1月1日至2014年12月31日期间从监测、流行病学和最终结果（SEER）项目中诊断为恶性直肠癌的患者。将患者分为5个CRM组，以比较基线特征并评估癌症特异性生存期（CSS）：0 - 1 mm、1.1 - 2.0 mm、2.1 - 5.0 mm、5.1 - 10.0 mm和>10 mm。主要终点是CSS。环周切除边缘≤1 mm与直肠癌中癌症特异性死亡率风险增加99%独立相关[风险比（HR）= 1.990，95%置信区间（CI）= 1.613 - 2.454，P < 0.001，使用CRM（1.1 - 2.0 mm）作为参考]。CRM（5.1 - 10.0 mm）与癌症特异性死亡风险降低29.2%独立相关[HR = 0.708，95% CI = 0.525 - 0.954，P = 0.152，使用组（2.1 - 5.0 mm）作为参考]。CRM ≤2 mm或≤0.4 mm与CSS无明显相关性。环周切缘是直肠癌的独立预后因素。外科医生应尽量扩大CRM。CRM ≤1 mm的直肠癌患者应根据个人情况给予更多的术后关注。此外，CRM应在术前磁共振成像或病理报告中以毫米为单位准确测量，而不是简单地描述为“参与”或“清晰”。
This study aimed to investigate circumferential resection margin (CRM) as a prognostic factor for long‐term oncologic survival after rectal cancer surgery. Patients diagnosed with malignant rectal cancer between 1 January 2010 and 31 December 2014, from the Surveillance, Epidemiology, and End Results (SEER) program were identified for this study. The patients were divided into five CRM groups to compare the baseline characteristics and assess cancer‐specific survival (CSS): 0‐1 mm, 1.1‐2.0 mm, 2.1‐5.0 mm, 5.1‐10.0 mm, and >10 mm. The main endpoint was CSS. Circumferential resection margin ≤1 mm was independently associated with 99% increased risk of cancer‐specific mortality in rectal cancer [hazard ratio (HR) = 1.990, 95% confidence interval (CI) = 1.613‐2.454, P < 0.001, using CRM (1.1‐2.0 mm) as a reference]. CRM (5.1‐10.0 mm) was independently associated with 29.2% decreased risk of cancer‐specific mortality [HR = 0.708, 95% CI = 0.525‐0.954, P = 0.152, using group (2.1‐5.0 mm) as reference]. CRM ≤2 mm or ≤0.4 mm was not obviously associated with CSS. circumferential resection margin is an independent prognostic factor in rectal cancer. Surgeons should try to maximize the CRM. Rectal cancer patients with CRM ≤1 mm should receive more postoperative attention depending on individual situation. Also, CRM should be accurately measured in millimeters in a preoperative magnetic resonance imaging or pathological report, rather than simply described as “involved” or “clear.”
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影响因子：
3.8
作者：
Kwon KA;Kim SH;Oh SY;Lee S;Han JY;Kim KH;Goh RY;Choi HJ;Park KJ;Roh MS;Kim HJ;Kwon HC;Lee JH
通讯作者：
Lee JH
影响因子：
168.9
作者：
ADAM, IJ;MOHAMDEE, MO;QUIRKE, P
通讯作者：
QUIRKE, P
影响因子：
45.3
作者：
Nagtegaal, ID;van de Velde, CJH;van Krieken, JHJM
通讯作者：
van Krieken, JHJM
影响因子：
10.3
作者：
Fokas, Emmanouil;Stroebel, Philipp;Roedel, Claus
通讯作者：
Roedel, Claus
影响因子：
5.6
作者：
Nagtegaal, ID;Marijnen, CAA;van Krieken, JHJM
通讯作者：
van Krieken, JHJM