Mesorectal Grades Predict Recurrences After Curative Resection for Rectal Cancer

Abstract

The macroscopic quality of mesorectum after curative excision of rectal cancer is an important predictor of local and overall recurrences. The mesorectal grades may be of value in decisions regarding postoperative adjuvant therapy.

Diagnostic Accuracy of MRI for Assessment of T Category, Lymph Node Metastases, and Circumferential Resection Margin Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-analysis

“…In a prospective study of 130 patients who underwent curative resection with attempted TME, positive CRM was significantly higher in patients with incomplete TME (29.4%) compared with complete (1.6%) and nearly complete (5.8%) TME (p=0.0001). Local recurrence rose in parallel, from 1.6% and 5.7% respectively after complete and nearly complete TME to 41% after incomplete TME (p=0.0001) (29). The relationship between TME quality, positive CRM, and local recurrence was confirmed by data from the international multicentre CR07 trial which compared the impact of short course preoperative radiotherapy versus selective postoperative chemoradiotherapy on outcomes of patients with resectable Stage I-III rectal cancer (30).…”

Recidiva pélvica de adenocarcinoma de reto: abordagem cirúrgica

“…Entre 3% a 35% dos doentes evoluirão com recidiva local. (3,5,6,7,8) Os fatores que estão implicados nas diferentes taxas de recidiva observadas na literatura, são aqueles relacionados à técnica operatória e à própria biologia do tumor. O estadiamento inicial da neoplasia é um dos fatores relacionados à biologia tumoral, sendo considerado o mais importante.…”

“…A ressecção cirúrgica do segmento acometido com adenocarcinoma retal aliada à excisão total do mesorreto (ETM), além da neoadjuvância, tem sido preconizada para o tratamento desta afecção, com redução das taxas de recidiva local. (1,2,3,4,5,6) No entanto, a recidiva pélvica após ressecção curativa do câncer retal, continua influenciando na sobrevida dos doentes, e constituindo importante causa de morbidade pós-operatória. Entre 3% a 35% dos doentes evoluirão com recidiva local.…”

Grading quality of total mesorectal excision specimen by surgeons

“…Besides that, local recurrence depends upon quality of TME which has shown that incomplete TME have local recurrence and was 41%,whereas in near complete it was 6% and in complete TME the rate was less than 2% 14 .…”