Factors that influence the adequacy of total mesorectal excision for rectal cancer

Abstract

There is no relationship between the TME score in patients undergoing resectional surgery for adenocarcinoma of the rectum and the development of local recurrence at 2 years. Other factors such as CRM involvement are more likely to have an impact on local recurrence. The factors that influence the quality of TME are the operative procedure of anterior resection, male gender and CRM positivity. There appear to be no deleterious effects on the TME score by Specialist Registrars performing the operation under Consultant supervision. While TME scores may be an index of a technical performance, they appear to have little role in predicting future outcomes.

Practice Guideline for the Surveillance of Patients After Curative Treatment of Colon and Rectal Cancer

“…8 the american Cancer society and the us multi-society task force recommend sigmoidoscopy or endorectal ultrasound every 3 to 6 months 73-77 for the first 2 years after resection. 2 those patients undergoing traditional abdominal resection (ie, low anterior resection) with certain risk factors such as male sex, distal lesions, close distal margins, inadequate total mesorectal excision, positive circumferential resection margin, positive lymph nodes, and high-risk tumor markers (eg, poorly differentiated, lymphovascular invasion, tumor ulceration) [78][79][80][81] have higher risk of recurrence and consideration should be given to more frequent surveillance during the initial surveillance period (every 6 months versus annually). another important risk factor is poor response to neoadjuvant chemoradiation therapy.…”

CT/MRI pelvimetry as a useful tool when selecting patients with rectal cancer for transanal total mesorectal excision

“…The quality (i.e., completeness) of a TME is histopathologically evaluated, which objectifies the true radicality of the surgical procedure [2]. An incomplete TME is unambiguously associated with increased incidence of local recurrence [3][4][5].…”

A novel prognostic index in colorectal cancer defined by serum carcinoembryonic antigen and plasma tissue inhibitor of metalloproteinases-1

“…Patients with RC were operated on at a time before introduction of the total mesorectal excision (TME) [30] approach to the rectum and they did not receive any pre-and/or postoperative radiotherapy. More recent results suggest that CC and RC patients may have similar DFS, while CC patients still have a better overall survival than RC patients [31][32][33].…”