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Prognosis and Risk Factors in Patients With Non-radical Circumferential Resection Margin After Rectal Cancer Surgery

Ehrnrooth, Beatrice ; Agger, Erik LU orcid ; Buchwald, Pamela LU and Dahlbäck, Cecilia LU (2026) In In Vivo 40(1). p.296-302
Abstract
Background/Aim: Circumferential resection margin (CRM) has been shown to be a strong predictor of risk of local recurrence (LR) and distant metastases (DM) in patients with rectal cancer treated with total mesorectal excision (TME). However, not all patients with a CRM of zero develop LR or DM. This study aimed to identify factors associated with disease-free survival (DFS) despite non-radical excision (CRM=0 mm). Patients and Methods: Patients surgically treated for adenocarcinoma of the rectum between 2005 and 2013 were identified through the Swedish ColoRectal Cancer Registry. Results: Of 8, 392 patients included in the study, 159 (1.8%) were found to have CRM 0 mm. The rates of LR (n=27; 17%) and DM (n=62; 39%) were high in the CRM 0... (More)
Background/Aim: Circumferential resection margin (CRM) has been shown to be a strong predictor of risk of local recurrence (LR) and distant metastases (DM) in patients with rectal cancer treated with total mesorectal excision (TME). However, not all patients with a CRM of zero develop LR or DM. This study aimed to identify factors associated with disease-free survival (DFS) despite non-radical excision (CRM=0 mm). Patients and Methods: Patients surgically treated for adenocarcinoma of the rectum between 2005 and 2013 were identified through the Swedish ColoRectal Cancer Registry. Results: Of 8, 392 patients included in the study, 159 (1.8%) were found to have CRM 0 mm. The rates of LR (n=27; 17%) and DM (n=62; 39%) were high in the CRM 0 mm group; however, more than half of these patients developed neither (n=84; 52.8%). Stage II disease was associated with a higher DFS [odds ratio (OR)=2.15; 95% confidence interval (CI)=1.11-4.18] compared with stage III disease. Neoadjuvant chemotherapy was a negative prognostic factor of DFS (OR=0.47, 95% CI=0.23-0.97) independent of the stage of disease. Conclusion: Over half of the patients with CRM 0 mm after rectal cancer surgery did not develop LR or DM. Lower stage of disease and no neoadjuvant chemotherapy were associated with a better DFS. These findings suggest that other biological or molecular factors may influence prognosis after non-radical excision, highlighting the need for further research to improve postoperative management and follow-up. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
In Vivo
volume
40
issue
1
pages
296 - 302
publisher
International Institute of Anticancer Research
external identifiers
  • pmid:41482372
  • scopus:105026525461
ISSN
0258-851X
DOI
10.21873/invivo.14192
language
English
LU publication?
yes
id
1fadd006-fb26-42c4-b40d-36a580ca0bdb
date added to LUP
2026-02-03 23:46:04
date last changed
2026-02-04 07:36:08
@article{1fadd006-fb26-42c4-b40d-36a580ca0bdb,
  abstract     = {{Background/Aim: Circumferential resection margin (CRM) has been shown to be a strong predictor of risk of local recurrence (LR) and distant metastases (DM) in patients with rectal cancer treated with total mesorectal excision (TME). However, not all patients with a CRM of zero develop LR or DM. This study aimed to identify factors associated with disease-free survival (DFS) despite non-radical excision (CRM=0 mm). Patients and Methods: Patients surgically treated for adenocarcinoma of the rectum between 2005 and 2013 were identified through the Swedish ColoRectal Cancer Registry. Results: Of 8, 392 patients included in the study, 159 (1.8%) were found to have CRM 0 mm. The rates of LR (n=27; 17%) and DM (n=62; 39%) were high in the CRM 0 mm group; however, more than half of these patients developed neither (n=84; 52.8%). Stage II disease was associated with a higher DFS [odds ratio (OR)=2.15; 95% confidence interval (CI)=1.11-4.18] compared with stage III disease. Neoadjuvant chemotherapy was a negative prognostic factor of DFS (OR=0.47, 95% CI=0.23-0.97) independent of the stage of disease. Conclusion: Over half of the patients with CRM 0 mm after rectal cancer surgery did not develop LR or DM. Lower stage of disease and no neoadjuvant chemotherapy were associated with a better DFS. These findings suggest that other biological or molecular factors may influence prognosis after non-radical excision, highlighting the need for further research to improve postoperative management and follow-up.}},
  author       = {{Ehrnrooth, Beatrice and Agger, Erik and Buchwald, Pamela and Dahlbäck, Cecilia}},
  issn         = {{0258-851X}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{296--302}},
  publisher    = {{International Institute of Anticancer Research}},
  series       = {{In Vivo}},
  title        = {{Prognosis and Risk Factors in Patients With Non-radical Circumferential Resection Margin After Rectal Cancer Surgery}},
  url          = {{http://dx.doi.org/10.21873/invivo.14192}},
  doi          = {{10.21873/invivo.14192}},
  volume       = {{40}},
  year         = {{2026}},
}