Prognostic value of circumferential resection margin in T3N0M0 esophageal squamous cell carcinoma

Yang, Yu‐Shang; Wang, Yun-Cang; Deng, Han‐Yu; Yuan, Yong; Wang, Zhiqiang; He, Du; Chen, Long-Qi

doi:10.21037/atm.2018.06.49

Cited by 8 publications

(11 citation statements)

References 14 publications

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“…In order to investigate whether lymph node status would affect the prognostic signi cance of CRM status, we performed a subgroup analysis based on the number of lymph node metastases. Similar to the ndings of Yang et al [4], CRM status, according to either CAP or RCP criteria, was a risk factor affecting the prognosis of patients within the pN0 group, but the survival difference between CRM 0 mm and CRM 0-1 mm was not statistically signi cant. In the pN1-2 group, patients with CRM 0 mm had worse survival than ones with CRM 0-1 mm and CRM >1 mm, and patients with CRM 0-1 mm had worse survival than ones with CRM >1 mm, but the survival difference between patients with CRM 0-1 mm and CRM >1 mm was not statistically signi cant.…”

Section: Discussionsupporting

confidence: 82%

“…Notably, some patients in this study ever received neoadjuvant therapy [6]. Different from the above studies, Yang et al [4] failed to demonstrate positive CRM, according to either the CAP criteria or the RCP criteria, had signi cant association…”

Section: Discussionmentioning

confidence: 56%

“…Even though the role of positive CRM in esophageal cancer has been investigated for decades, but it is still controversial. Many articles showed that there was signi cant relationship between positive CRM and local-regional recurrence, disease-free survival (DFS), and overall survival (OS) [4][5][6][7][8][9]. However, some studies were unable to show an effect of positive CRM on OS and tumor recurrence [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies also proposed other CRM criteria. Yang et al [4] suggested CRM 600 µm as the optimal cut-off point, and this modi ed CRM criteria had better prognostic power than the traditional criteria in ESCC patients. In addition to the above two-tier criteria, other studies also proposed the 500µm-three-tier criteria [6].…”

Section: Introductionmentioning

confidence: 99%

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The Prognostic Significance of the Circumferential Resection Margin in Esophageal Squamous Cell Carcinoma Patients Without Neoadjuvant Treatment

Yang

Lin

Wang

et al. 2022

Preprint

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Background: Circumferential resection margin (CRM) is very important in esophageal cancer, but its diagnostic criteria has not been unified. The College of American Pathologists (CAP) and the Royal College of Pathologists (RCP) provide two different criteria. The aim of this study is to evaluate the long-term prognostic significance of CRM status with different CRM criteria in esophageal squamous cell carcinoma (ESCC).Methods: Influence of CRM status according to the CAP and RCP criteria on long-term survival of 838 patients with resected pT3 tumors and without neoadjuvant therapy was analyzed. Patients stratified into three groups on the basis of tumor distance from the CRM (>1 mm, 0-1 mm, 0 mm) were also analysed.Results: Positive CRM was found in 59 (7%) patients according to the CAP criteria and 317(37.8%) patients according to the RCP criteria. Univariate and multivariate survival analysis showed that CRM status, according to three different criteria, was independent prognostic factor. However, subgroup analysis showed that the prognostic value of CRM status was limited to certain metastatic lymph node load. In pN0 subgroup, patients with CRM > 1mm had better prognosis than patients with CRM 0-1mm. Patients with CRM 0 mm had worse outcome than patients with CRM > 0 mm in pN1-2 subgroup. But CRM status had no prognosis value in pN3 subgroups. Conclusions: The CRM status is an important prognostic factor in ESCC patients, but this effect was limited to patients without or with less lymph node metastasis (pN0-2). In clinical practice, we recommend the three-tier criteria as it provides more prognostic value than the traditional two-tier criteria.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Prognostic Significance of the Circumferential Resection Margin in Esophageal Squamous Cell Carcinoma Patients Without Neoadjuvant Treatment

Yang

Lin

Wang

et al. 2022

Preprint

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“…Reclassifying CRM with a cutoff value of 600 microns showed better OS with CRM > 600 microns than CRM < 600 microns (p=.003). 30…”

Section: Impact On Survivalmentioning

confidence: 99%

Importance of Circumferential Resection Margin in Management of Esophageal Cancer

Thakur

Devkota

et al. 2020

Nep. J. Cancer

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Esophagectomy (R0) remains the gold standard for the management of esophageal cancer. But due to close vicinity of esophagus with the major structures like heart, aorta, vertebral column, tracheobronchial tree and lungs, a wider circumferential resection is generally not possible and a R1/ R2 resection might occur. Therefore, locoregional recurrence rates of esophageal cancer are reported to be as high as 52%. The Royal College of Pathologists (RCP) and The College of American Pathologists (CAP) define circumferential resection margin (CRM) differently. A mean overall CRM involvement was found to be 40.7% (RCP criteria) and 11.8% (CAP criteria). Twometa-analyses have shown poor survival in CRM positive cases. CRM positivity in T1/ T2 lesions should not occur unless there is a surgical fault. For T3 lesions, a higher rate of CRM positivity has been documented. Therefore, a wider CRM using transthoracic approach appears mandatory, especially for T3 lesions.

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Macroscopic Examination of Surgical Specimen of Esophageal Squamous Cell Carcinoma

Lam

2020

Methods in Molecular Biology

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Prognostic value of circumferential resection margin in T3N0M0 esophageal squamous cell carcinoma

Abstract: Our study highlighted that CRM was an independent prognostic factor for survival in esophageal cancer patients, and the modified CRM criteria had better prognostic power than the traditional criteria in patients with ESCC.

Cited by 8 publications

References 14 publications

The Prognostic Significance of the Circumferential Resection Margin in Esophageal Squamous Cell Carcinoma Patients Without Neoadjuvant Treatment

The Prognostic Significance of the Circumferential Resection Margin in Esophageal Squamous Cell Carcinoma Patients Without Neoadjuvant Treatment

Importance of Circumferential Resection Margin in Management of Esophageal Cancer

Macroscopic Examination of Surgical Specimen of Esophageal Squamous Cell Carcinoma

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