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Circumferential resection margin is a predictor for metastatic disease after rectal cancer surgery: a nation-wide population-based study cohort

Agger, Erik LU orcid ; Jörgren, Fredrik LU ; Lydrup, Marie-Louise LU and Buchwald, Pamela LU (2021) European Colorectal Conference In Techniques in Coloproctology 25. p.624-624
Abstract
Background/Aim To evaluate circumferential resection margin
(CRM) as a risk factor for distant metastasis (DM) in rectal cancer.
The treatment of rectal cancer has evolved over the last decades.
Surgical radicality is the single most important factor in preventing
recurrences, both locally and distantly. CRM B 1.0 mm is considered
to increase recurrence risk. However, not all patients with CRM
B 1.0 mm suffer recurrence. This study explores the risk of DM in
relation to exact CRM. Methods All patients treated with abdominal
resection surgery for rectal cancer between 2005 and 2013 in Sweden
were eligible for inclusion in this retrospective study. Primary endpoint was DM. Results 12,146 cases were... (More)
Background/Aim To evaluate circumferential resection margin
(CRM) as a risk factor for distant metastasis (DM) in rectal cancer.
The treatment of rectal cancer has evolved over the last decades.
Surgical radicality is the single most important factor in preventing
recurrences, both locally and distantly. CRM B 1.0 mm is considered
to increase recurrence risk. However, not all patients with CRM
B 1.0 mm suffer recurrence. This study explores the risk of DM in
relation to exact CRM. Methods All patients treated with abdominal
resection surgery for rectal cancer between 2005 and 2013 in Sweden
were eligible for inclusion in this retrospective study. Primary endpoint was DM. Results 12,146 cases were identified. 8593 cases were
analysed after exclusion. 718 (8.6%) patients had CRM B 1.0 mm
and 7601 (91.4%) patients CRM [1.0 mm. DM rate was 36.9%
(n = 56/153), 29.2% (n = 165/565), 25.2% (n = 26/103) and 18.5%
(n = 1385/7498) when CRM was 0.0 mm, 0.1–1.0 mm, 1.1–1.9 mm
and CRM C 2 mm respectively. Multivariable analysis revealed
higher DM risk in CRM 0.0 mm versus C 2.0 mm (HR 1.73, 95% c.i.
1.30 to 2.29; P B 0.001) and in CRM 0.1–1.0 mm versus C 2.0 mm
(HR 1.29, 95% c.i. 1.09 to 1.53; P B 0.001). No significant difference
in DM risk in CRM 1.1–1.9 mm versus C 2.0 mm (HR 1.10, 95% c.i.
0.74 to 1.64; P = 0.623) could be detected. Conclusion The risk of
DM decreases with increasing CRM. Moreover, CRM\ 2.0 mm is
an independent, significant risk factor for DM. CRM should be considered when predicting risk of DM after rectal cancer surgery. (Less)
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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Techniques in Coloproctology
volume
25
pages
624 - 624
publisher
Springer
conference name
European Colorectal Conference
conference location
St Gallen, Switzerland
conference dates
2020-11-29 - 2020-12-02
ISSN
1123-6337
DOI
10.1007%2Fs10151-021-02408-9
language
English
LU publication?
no
id
d3f7a595-c861-413c-97e5-29e2747bef39
date added to LUP
2021-11-06 09:15:01
date last changed
2021-11-08 09:36:04
@misc{d3f7a595-c861-413c-97e5-29e2747bef39,
  abstract     = {{Background/Aim To evaluate circumferential resection margin<br/>(CRM) as a risk factor for distant metastasis (DM) in rectal cancer.<br/>The treatment of rectal cancer has evolved over the last decades.<br/>Surgical radicality is the single most important factor in preventing<br/>recurrences, both locally and distantly. CRM B 1.0 mm is considered<br/>to increase recurrence risk. However, not all patients with CRM<br/>B 1.0 mm suffer recurrence. This study explores the risk of DM in<br/>relation to exact CRM. Methods All patients treated with abdominal<br/>resection surgery for rectal cancer between 2005 and 2013 in Sweden<br/>were eligible for inclusion in this retrospective study. Primary endpoint was DM. Results 12,146 cases were identified. 8593 cases were<br/>analysed after exclusion. 718 (8.6%) patients had CRM B 1.0 mm<br/>and 7601 (91.4%) patients CRM [1.0 mm. DM rate was 36.9%<br/>(n = 56/153), 29.2% (n = 165/565), 25.2% (n = 26/103) and 18.5%<br/>(n = 1385/7498) when CRM was 0.0 mm, 0.1–1.0 mm, 1.1–1.9 mm<br/>and CRM C 2 mm respectively. Multivariable analysis revealed<br/>higher DM risk in CRM 0.0 mm versus C 2.0 mm (HR 1.73, 95% c.i.<br/>1.30 to 2.29; P B 0.001) and in CRM 0.1–1.0 mm versus C 2.0 mm<br/>(HR 1.29, 95% c.i. 1.09 to 1.53; P B 0.001). No significant difference<br/>in DM risk in CRM 1.1–1.9 mm versus C 2.0 mm (HR 1.10, 95% c.i.<br/>0.74 to 1.64; P = 0.623) could be detected. Conclusion The risk of<br/>DM decreases with increasing CRM. Moreover, CRM\ 2.0 mm is<br/>an independent, significant risk factor for DM. CRM should be considered when predicting risk of DM after rectal cancer surgery.}},
  author       = {{Agger, Erik and Jörgren, Fredrik and Lydrup, Marie-Louise and Buchwald, Pamela}},
  issn         = {{1123-6337}},
  language     = {{eng}},
  note         = {{Conference Abstract}},
  pages        = {{624--624}},
  publisher    = {{Springer}},
  series       = {{Techniques in Coloproctology}},
  title        = {{Circumferential resection margin is a predictor for metastatic disease after rectal cancer surgery: a nation-wide population-based study cohort}},
  url          = {{http://dx.doi.org/10.1007%2Fs10151-021-02408-9}},
  doi          = {{10.1007%2Fs10151-021-02408-9}},
  volume       = {{25}},
  year         = {{2021}},
}