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Risk of local recurrence of rectal cancer and circumferential resection margin : population-based cohort study

Agger, E. A. LU orcid ; Jörgren, F. H. LU ; Lydrup, M. L.A. LU and Buchwald, P. L. LU (2020) In British Journal of Surgery 107(5). p.580-585
Abstract

Background: A circumferential resection margin (CRM) of 1·0 mm or less after rectal cancer surgery is thought to increase the risk of local recurrence (LR). This retrospective population-based study examined how CRM distance affects the LR risk. Methods: Data from the Swedish Colorectal Cancer Registry were used in a retrospective analysis of rectal cancers resected between 2005 and 2013. The primary endpoint was LR. Results: A total of 12 146 patients were identified, of whom 8392 were included in the analysis; 739 patients had a CRM of 1·0 mm or less and 7653 had a CRM larger than 1·0 mm. The mean follow-up time was 51 months. There were 66 LRs (8·9 per cent) in the group with a CRM of 1·0 mm or less, and 256 (3·3 per cent) among... (More)

Background: A circumferential resection margin (CRM) of 1·0 mm or less after rectal cancer surgery is thought to increase the risk of local recurrence (LR). This retrospective population-based study examined how CRM distance affects the LR risk. Methods: Data from the Swedish Colorectal Cancer Registry were used in a retrospective analysis of rectal cancers resected between 2005 and 2013. The primary endpoint was LR. Results: A total of 12 146 patients were identified, of whom 8392 were included in the analysis; 739 patients had a CRM of 1·0 mm or less and 7653 had a CRM larger than 1·0 mm. The mean follow-up time was 51 months. There were 66 LRs (8·9 per cent) in the group with a CRM of 1·0 mm or less, and 256 (3·3 per cent) among patients with a CRM larger than 1·0 mm. The LR rate was 17·0 per cent (27 of 159), 6·7 per cent (39 of 580), 1·9 per cent (2 of 103) and 3·4 per cent (254 of 7550) when the CRM was 0, 0·1–1·0, 1·1–1·9 and at least 2·0 mm respectively. The risk of LR among patients with a CRM of 0 mm was higher than that in all other subgroups with a larger CRM (P < 0·050). There was no difference in LR between the subgroups with CRM 1·1–1·9 mm and at least 2·0 mm. LR was diagnosed earlier when the CRM was 1·0 mm or less. Conclusion: LR risk is related to exact CRM, with the highest risk in patients with a CRM of 0 mm. Close monitoring of patients with no measurable clear margin may allow early detection of LR.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
107
issue
5
pages
6 pages
publisher
Oxford University Press
external identifiers
  • pmid:32133651
  • scopus:85082097449
ISSN
0007-1323
DOI
10.1002/bjs.11478
language
English
LU publication?
yes
id
6cd52896-139f-46f5-9ff0-4ebc73ed5262
date added to LUP
2020-04-02 14:46:09
date last changed
2024-04-17 06:42:49
@article{6cd52896-139f-46f5-9ff0-4ebc73ed5262,
  abstract     = {{<p>Background: A circumferential resection margin (CRM) of 1·0 mm or less after rectal cancer surgery is thought to increase the risk of local recurrence (LR). This retrospective population-based study examined how CRM distance affects the LR risk. Methods: Data from the Swedish Colorectal Cancer Registry were used in a retrospective analysis of rectal cancers resected between 2005 and 2013. The primary endpoint was LR. Results: A total of 12 146 patients were identified, of whom 8392 were included in the analysis; 739 patients had a CRM of 1·0 mm or less and 7653 had a CRM larger than 1·0 mm. The mean follow-up time was 51 months. There were 66 LRs (8·9 per cent) in the group with a CRM of 1·0 mm or less, and 256 (3·3 per cent) among patients with a CRM larger than 1·0 mm. The LR rate was 17·0 per cent (27 of 159), 6·7 per cent (39 of 580), 1·9 per cent (2 of 103) and 3·4 per cent (254 of 7550) when the CRM was 0, 0·1–1·0, 1·1–1·9 and at least 2·0 mm respectively. The risk of LR among patients with a CRM of 0 mm was higher than that in all other subgroups with a larger CRM (P &lt; 0·050). There was no difference in LR between the subgroups with CRM 1·1–1·9 mm and at least 2·0 mm. LR was diagnosed earlier when the CRM was 1·0 mm or less. Conclusion: LR risk is related to exact CRM, with the highest risk in patients with a CRM of 0 mm. Close monitoring of patients with no measurable clear margin may allow early detection of LR.</p>}},
  author       = {{Agger, E. A. and Jörgren, F. H. and Lydrup, M. L.A. and Buchwald, P. L.}},
  issn         = {{0007-1323}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{580--585}},
  publisher    = {{Oxford University Press}},
  series       = {{British Journal of Surgery}},
  title        = {{Risk of local recurrence of rectal cancer and circumferential resection margin : population-based cohort study}},
  url          = {{http://dx.doi.org/10.1002/bjs.11478}},
  doi          = {{10.1002/bjs.11478}},
  volume       = {{107}},
  year         = {{2020}},
}