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KMID : 0356720130290060231
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Journal of the Korean Society of Coloproctology
2013 Volume.29 No. 6 p.231 ~ p.237
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Association Between a Close Distal Resection Margin and Recurrence After a Sphincter-Saving Resection for T3 Mid- or Low-Rectal Cancer Without Radiotherapy
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Han Jae-Woong
Park Ha-Kyung
Shin Jae-Ho
An Min-Sung
Ha Tae-Kwun
Kim Kwang-Hee
Bae Ki-Beom
Kim Tae-Hyun
Choi Chang-Soo
Oh Sang-Hoon
Oh Min-Kyung
Kang Mi-Seon
Hong Kwan-Hee
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Abstract
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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
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KEYWORD
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Rectal neoplasms, Distal resection margin, Recurrence
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