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Ann Coloproctol. 2013 Dec;29(6):231-7. doi: 10.3393/ac.2013.29.6.231. Epub 2013 Dec 31.

Association between a close distal resection margin and recurrence after a sphincter-saving resection for t3 mid- or low-rectal cancer without radiotherapy.

Author information

1
Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
2
Clinical Trial Center in Pharmacology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
3
Department 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 ≤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.

KEYWORDS:

Distal resection margin; Rectal neoplasms; Recurrence

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