Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

Tzardi, Maria

doi:10.1159/000099170

Cited by 18 publications

(10 citation statements)

References 56 publications

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“…Nissan et al [10] found that serum CEA levels are a significant prognostic factor for both local control and overall survival. A significant prognostic factor for increased local recurrences and reduced survival in this study was incomplete resection, which has already been recognized as an important factor in the literature [8,19,20,21]. Furthermore, as previously reported by others [8, 10,22,23,24], a significantly reduced survival was identified in patients who underwent an abdominoperineal resection.…”

Section: Discussionsupporting

confidence: 80%

Preoperative Radiotherapy Has No Value for Patients with T2–3, N0 Adenocarcinomas of the Rectum

et al. 2009

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Background: Treatment of rectal cancer with preoperative radiotherapy followed by total mesorectal excision is nowadays the standard treatment. It reduces local recurrences and improves overall survival. However, in patients with T2–3, N0 rectal cancer, the role of preoperative radiotherapy remains controversial. The aim of this study was to review the benefit of radiotherapy in T2 and T3, N0 rectal cancer patients. Methods: Between 1996 and 2003, 103 patients with T2–3, N0 rectal cancer were identified in our prospective database. This study evaluated time to local recurrence, distant metastases and overall survival. Results: Median follow-up was 4.3 years. The 5-year local control rate was 94%. The 5-year overall survival was 65%. The 5-year disease-free survival rate was 82%. Preoperative radiotherapy did not show any statistical differences. Abdominal perineal resection and T3 tumors negatively influenced overall survival (p = 0.02). Advanced age was of significant importance in overall survival. Conclusions: Preoperative radiotherapy does not seem to be of significant importance in patients with T2–3, N0 rectal cancer regarding local recurrence and survival. Since preoperative radiotherapy is associated with short- and long-term morbidity, patients with T2–3, N0 tumors should be identified and treated with surgery alone.

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Section: Discussionsupporting

confidence: 80%

Preoperative Radiotherapy Has No Value for Patients with T2–3, N0 Adenocarcinomas of the Rectum

et al. 2009

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“…As circumferential resection margin and total mesorectal excision have become the consensus for rectal cancer [33, 34], alike definitions are introduced into pancreaticoduodenectomy. Besides traditional margins including bile duct margin, pancreatic neck margin, proximal and distal enteric margin, new margins have been studied.…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery margin in pancreaticoduodenectomy for pancreatic adenocarcinoma

Liu

Tian

et al. 2016

Oncotarget

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The aim of this study is trying to describe more details of superior mesenteric artery margin in pancreaticoduodenectomy for pancreatic ductal adenocarcinoma, to evaluate biological and prognostic implications of tumor budding in this margin, and to provide more evidence for evaluation of R0 surgery in pancreaticoduodenectomy. 46 patients in 5-years period are included in this study. Immunochemistry and immunofluorescence are used to analyze tumor budding and epithelial–mesenchymal transition. Superior mesenteric artery margin might be described from four aspects including location, gross appearance, microscopic appearance and tumor budding. We find that 1mm rule for R1 surgery is more appropriate to predict prognosis (P = 0.009) than 0mm rule (P = 0.141). Expression of cytokeratin in tumor budding is significantly lower than primary tumor (P = 0.001), and it suggests that tumor budding may participate the procedure of epithelial–mesenchymal transition. High-grade tumor budding and decreasing cytokeratin of tumor budding correlate with distant metastasis and has negative influence on prognosis. So superior mesenteric artery margin might be not only an area that tumor cells may invade, but also a pathway for distant metastasis. It is necessary to evaluate superior mesenteric artery margin in pancreaticoduodenectomy for pancreatic cancer.

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“…3 With the advent of total mesorectal excision for rectal carcinoma, several studies have demonstrated that negative surgical margin status is the most important prognostic factor for disease-free survival. [4][5][6] Patients with operable locally advanced or recurrent rectal carcinoma involving contiguous pelvic organs are considered for en-bloc excision of pelvic viscera "total pelvic exenteration" (TPE) to obtain negative margin RECHERCHE status in the hopes that the same impact on disease-free survival will be observed.…”

Section: Discussionmentioning

confidence: 99%

Total pelvic exenteration for rectal cancer: outcomes and prognostic factors

Domes

Colquhoun²,

Taylor³

et al. 2011

Can J Surg

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Background:To perform complete resection of locally advanced and recurrent rectal carcinoma, total pelvic exenteration (TPE) may be attempted. We identified disease-related outcomes and prognostic factors. Methods:We conducted a single-centre review of patients who underwent TPE for rectal carcinoma over a 10-year period. Results:We included 28 patients in our study. After a median follow-up of 35 months, 53.6% of patients were alive with no evidence of disease. The 3-year actuarial disease-free and overall survival rates were 52.2% and 75.1%, respectively. On univariate analysis, recurrent disease, preoperative body mass index greater than 30 and lymphatic invasion were poor prognostic factors for disease-free survival, and only lymphatic invasion predicted overall survival. Additionally, multivariate analysis identified lymphatic invasion as an independent poor prognostic factor for disease-free survival in this patient population with locally advanced and recurrent rectal carcinoma. Conclusion:Despite the significant morbidity, TPE can provide long-term survival in patients with rectal carcinoma. Additionally, lymphatic invasion on final pathology was an independent prognostic factor for disease-free survival.Contexte : Pour pratiquer une résection complète du cancer du rectum avancé au stade local et récidivant, on peut tenter une exentération pelvienne totale (EPT). Nous avons déterminé des résultats liés à la maladie et des facteurs de pronostic. Méthodes :Nous avons procédé à une étude unicentrique portant sur des patients qui ont subi une EPT pour un cancer du rectum au cours d'une période de 10 ans.

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Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

Cited by 18 publications

References 56 publications

Preoperative Radiotherapy Has No Value for Patients with T2–3, N0 Adenocarcinomas of the Rectum

Preoperative Radiotherapy Has No Value for Patients with T2–3, N0 Adenocarcinomas of the Rectum

Superior mesenteric artery margin in pancreaticoduodenectomy for pancreatic adenocarcinoma

Total pelvic exenteration for rectal cancer: outcomes and prognostic factors

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