Mesorectal excision for rectal cancer: A view from Europe

Wiig, Johan N.; Carlsen, Erik; Søreide, Odd

doi:10.1002/(sici)1098-2388(199809)15:2<78::aid-ssu4>3.0.co;2-2

Cited by 46 publications

(4 citation statements)

References 83 publications

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“…However, not all reported LRRs after TME were lower than 10%; in some studies, 5 , 6 the LRRs were 11%–19%. Some researchers pointed out it was very likely that not all so-called TME procedures completely removed the mesorectum, which means that some of these TME surgical treatments failed to meet oncological quality standards.…”

Section: Introductionmentioning

confidence: 95%

The quality of total mesorectal excision specimen: A review of its macroscopic assessment and prognostic significance

Song

Pan

et al. 2018

Chronic Diseases and Translational Medicine

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As a surgical procedure which could significantly lower the recurrence rate of cancers, total mesorectal excision (TME) has been the gold standard for middle and lower rectal cancer treatment. However, previous studies have shown that the procedure did not achieve the ideal theoretical local recurrence rates of rectal cancers. Some researchers pointed out it was very likely that not all so-called TME treatments completely removed the mesorectum, implying that some of these TME surgical treatments failed to meet oncological quality standards. Therefore, a suitable assessment tool for the surgical quality of TME is necessary. The notion of “macroscopic assessment of mesorectal excision (MAME)” was put forward by some researchers as a better assessment tool for the surgical quality of TME and has been confirmed by a series of studies. Besides providing rapid and accurate surgical quality feedbacks for surgeons, MAME also effectively assesses the prognosis of patients with rectal cancer. However, as a new assessment tool used for TME surgical quality, MAME has an only limited influence on the current guidelines and is yet to be widely applied in most countries. The aims of this review are to provide a detailed introduction to MAME for clinical practice and to summarize the current prognostic significance of MAME.

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Section: Introductionmentioning

confidence: 95%

The quality of total mesorectal excision specimen: A review of its macroscopic assessment and prognostic significance

Song

Pan

et al. 2018

Chronic Diseases and Translational Medicine

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“…[2][3][4][5] The incidence of LR rectal cancer before the adoption of total mesorectal excision was 40% to 50% in patients with advanced-stage disease, [6] but the broad adoption of this approach has reduced the incidence to <10%. [7] In addition, preoperative neoadjuvant chemoradiotherapy with subsequent total mesorectal excision has further reduced the incidence of LR of rectal cancer in several clinical trials. [8,9] LR in patients with CRC is always associated with a poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Genomic evolution during locoregional recurrence in colorectal cancer determined by whole-exome sequencing: a retrospective observational study

Lan

Zhang³

et al. 2022

J Bio-X Res

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Objective: The genomic landscapes of metastatic colorectal cancer (mCRC) have been extensively studied; however, the genetic mechanisms underlying the locoregional recurrence (LR) of CRC remain unclear. The objective of our study was to investigate genomic evolution during LR in CRC using high-throughput sequencing. Methods: Twenty-three CRC patients with matched primary and LR tissues were recruited from Nanfang Hospital and Zhejiang Cancer Hospital between January 2011 and December 2018. The last date of follow-up was March 2020. Tissue samples were analyzed by whole-exome sequencing and the genomic profiles were depicted by single nucleotide variation, mutational signature, copy number variation, clonal architecture, and other features. The evolutionary process was speculated with comparison of the genetic variations between primary and LR lesions. The disseminating clusters from primary to LR lesions were identified by variant allele frequency dynamics. Furthermore, the early-recurrent biomarker was explored by comparing the indel signature between early- and late-recurrent patients. The study was approved by the Institutional Review Board of Nanfang Hospital of Southern Medical University (approval No. 2020010) on September 11, 2020. Results: The results highlighted distinct origins of LR between patients with high microsatellite instability and microsatellite stability. LR lesions evolved independently in patients with high microsatellite instability, while LR lesions were highly clonally related to the primary lesions in patients with microsatellite stability. Late-acquired variations in LR lesions encompassed a wide range of driver genes involved in histone methylation, DNA replication, T cell activation, PDCD1 gain, and LMNA loss. Furthermore, clonal analysis of the disseminating cells identified a dominant polyclonal seeding pattern during LR. The indel signature ID4 was associated with significantly shorter disease-free survival in patients with relapsed CRC according to a public dataset. Conclusion: These findings pose a challenge for the development of new approaches targeting the interactions of multiple clones in the establishment of LR and in terms of optimizing the clinical management of susceptible patients.

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“…Due to its superior benefit on local disease control and on adverse side effects, preoperative radio‐chemotherapy is accepted to be superior to postoperative radio‐chemotherapy [2, 4]. Even in patients with a total mesorectal excision (TME), almost 30 % show a positive circumferential resection margin with a high risk for local recurrence [5, 6]. Intraoperative radiotherapy (IORT) provides an effective high radiation dose to achieve local disease control with reduced exposure of the adjacent organs [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Influence of Intraoperative Radiotherapy (IORT) on Perioperative Outcome after Surgical Resection of Rectal Cancer

et al. 2013

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Mesorectal excision for rectal cancer: A view from Europe

Cited by 46 publications

References 83 publications

The quality of total mesorectal excision specimen: A review of its macroscopic assessment and prognostic significance

The quality of total mesorectal excision specimen: A review of its macroscopic assessment and prognostic significance

Genomic evolution during locoregional recurrence in colorectal cancer determined by whole-exome sequencing: a retrospective observational study

Influence of Intraoperative Radiotherapy (IORT) on Perioperative Outcome after Surgical Resection of Rectal Cancer

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