Histological processing variability in the determination of lateral resection margins in rectal cancer

Abstract

These results suggest that the fixation period/laboratory processes result in measurable differences in the reported LRM. This degree of variation has implications for the reliable reporting of the LRM, predicting local recurrence rates and planning subsequent adjuvant radiotherapy.

What is a safe distal resection margin in rectal cancer patients treated by low anterior resection without preoperative radiotherapy?

“…On the other hand, this study included the results from every department of pathology at a national level, encompassing all of the variations in standards of examination that are likely to be present in most countries, and thus minimizing the probability of selection bias. Although tissue shrinkage from formalin fixation in general may have reached 10–30% [11,28], when the DRM is short, the effect of shrinkage is negligible.…”

Effect of Formalin Fixation on Surgical Margins in Breast Cancer Surgical Specimen

“…Formalin fixation of surgical specimen has been described in various types of tumors as being responsible for shrinkage of tumor specimen and its tumor-free margins. The various tumors that have been studied include colorectal, esophageal, skin, and, more recently, breast tumors [ 15 , 16 , 27 , 28 ]. The comparison of preformalin fixation macroscopic margin and postformalin fixation microscopic margin in principle may not seem compatible; however, it is the most convenient and practical way.…”

“…The comparison of preformalin fixation macroscopic margin and postformalin fixation microscopic margin in principle may not seem compatible; however, it is the most convenient and practical way. This method has already been described in assessing esophageal and colorectal as well as breast tumors in the past [ 27 , 28 ].…”

Extralevator abdominoperineal resections and the need for pathological assessment of fresh tissue specimens

“…Formalin-associated shrinkage is the second and more significant component of specimen shrinkage. Fixation in formalin can result in shrinkage or contraction of the tissue by up to 33%, increasing with time and occurring in both the longitudinal and the circumferential planes 3 5. One effect of formalin is dehydration 5.…”

“…Fixation in formalin can result in shrinkage or contraction of the tissue by up to 33%, increasing with time and occurring in both the longitudinal and the circumferential planes 3 5. One effect of formalin is dehydration 5. Formalin stabilises cellular structure by crosslinking proteins, glycoproteins, nucleic acids and polysaccharides, particularly at sites of primary amines such as lysine.…”