Ann Coloproctol.  2013 Dec;29(6):231-237. 10.3393/ac.2013.29.6.231.

Association Between a Close Distal Resection Margin and Recurrence After a Sphincter-Saving Resection for T3 Mid- or Low-Rectal Cancer Without Radiotherapy

Affiliations
  • 1Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. gsams@paik.ac.kr
  • 2Clinical Trial Center in Pharmacology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 3Department of Pathology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Abstract

PURPOSE
To maintain the patient's quality of life, surgeons strive to preserve the sphincter during rectal cancer surgery. This study evaluated the oncologic safety of a sphincter-saving resection with a distal resection margin (DRM) <1 cm without radiotherapy in T3, mid- or low-rectal cancer.
METHODS
This retrospective study enrolled 327 patients who underwent a sphincter-saving resection for proven T3 rectal cancer located <10 cm from the anal verge and without radiotherapy between January 1995 and December 2011. The oncologic outcomes included the 5-year cancer-specific survival, the local recurrence, and the systemic recurrence rates.
RESULTS
In groups A (DRM < or =1 cm) and B (DRM >1 cm), the 5-year cancer-specific survival rates were 81.57% and 80.03% (P = 0.8543), the 5-year local recurrence rates were 6.69% and 9.52% (P = 0.3981), and the 5-year systemic recurrence rates were 19.46% and 23.11% (P = 0.5750), respectively.
CONCLUSION
This study showed that the close DRM itself should not be a contraindication for a sphincter-saving resection for T3 mid- or low-rectal cancer without radiotherapy. However, a prospective randomized controlled trial including the effect of adjuvant therapy will be needed.

Keyword

Rectal neoplasms; Distal resection margin; Recurrence

MeSH Terms

Humans
Quality of Life
Radiotherapy*
Rectal Neoplasms
Recurrence*
Retrospective Studies
Survival Rate
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