Does circumferential tumor location affect the circumferential resection margin status in mid and low rectal cancer?

• Published in: Asian journal of surgery 2018-05, Vol.41 (3), p.257-263
• Main Authors: Kang, Byung Mo, Park, Yong-Koo, Park, Sun Jin, Lee, Kil Yeon, Kim, Chang Woo, Lee, Suk-Hwan
• Format: Article
• Language: English
• Subjects: circumferential resection margin; depth of invasion; rectal cancer; Surgery; tumor location
• ISSN: 1015-9584
• DOI: 10.1016/j.asjsur.2016.12.001

Summary Background/Objective The purpose of this study was to assess the impact of circumferential tumor location on circumferential resection margin (CRM) status and the depth of tumor invasion in mid and low rectal cancer. Methods We retrospectively analyzed whole-mount slides of 58 patients who underwent total mesorectal excision for mid and low rectal cancer. The rate of tumor-positive CRM was compared according to the circumferential tumor location. In 31 patients, morphometric analyses of whole-mount specimens were performed to measure the depth of tumor invasion according to circumferential tumor location. Results Among 58 patients, 50% of tumors were anterior tumor and 50% were nonanterior. A tumor-positive CRM was more observed frequently in anterior tumors than in nonanterior tumors (41.1% vs. 10.3%, p  = 0.007). In a multivariate analysis, anterior tumor was the only independent risk factor for a positive CRM (odds ratio 4.725, 95% confidence interval 1.102–20.261, p  = 0.037). In a morphometric analysis of 31 patients, the depth of tumor invasion from the muscularis mucosa was greater (11.9 mm vs. 6.6 mm, p  = 0.028) in those with anterior tumors. Conclusion Anterior tumors are associated with a higher risk of tumor-positive CRM and tend to exhibit deeper invasion in mid and low rectal cancer.