Distal Bowel Surgical Margin Shorter than 1 cm After Preoperative Radiation for Rectal Cancer: Is It Safe?

Abstract

After preoperative radiotherapy, distal bowel clearance < or =1 cm did not compromise local control.

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

“…The remaining 17 studies constituted the material for the current review. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Only one report prospectively explored the issue in question as the secondary end point. 20 The remaining reports were retrospective.…”

“…Two reports gathered the data from multicentre randomized studies. 17,20 The rest presented singlecenter data.…”

“…8,9,15,16,20 In none of these studies was the difference in local recurrence rate between the two groups statistically significant. In one study reported by Kiran et al, the multivariable analysis could not demonstrate an association.…”

“…In case of a lack of relevant information in the reports published by our group, information was extracted from the original databases. 5,9,20,23 In cases requiring additional clarification, the authors of the reports were contacted.…”

“…In the remaining 15 studies the difference in local recurrence rate between the short margin group and to the long margin group was not significant in univariate analysis. [7][8][9][10][11][12][13][15][16][17][19][20][21][22][23] Of the eight reports showing long-term survival, survival did not differ statistically between the two groups in seven; in one remaining study survival was lower in the short margin group compared to the long margin group ( Table 1).…”