Prognostic Impact of Circumferential Resection Margin in Rectal Cancer Treated with Preoperative Chemoradiotherapy

Abstract

After preoperative CRT, CRM distance provides useful information for risk stratification in the recurrence of rectal cancer.

Circumferential margin involvement after total mesorectal excision for mid or low rectal cancer: are all R1 resections equal?

“…Hwang et al . reported a disease‐free survival (DFS) which was significantly lower in patients with CRM = 0 mm than in patients with CRM between 0.1 and 1 mm. Park et al .…”

“…Two studies have evaluated the prognosis of patients after R1 resection specifically looking at CRM involvement . Hwang et al .…”

“…Two studies have evaluated the prognosis of patients after R1 resection specifically looking at CRM involvement [18,20]. Hwang et al [20] reported a disease-free survival (DFS) which was significantly lower in patients with CRM = 0 mm than in patients with CRM between 0.1 and 1 mm. Park et al reported a 5-year DFS which was significantly lower with a CRM between 0.5 mm and 1 mm than with a CRM ≤ 0.5 mm [18].…”

“…Park et al reported a 5-year DFS which was significantly lower with a CRM between 0.5 mm and 1 mm than with a CRM ≤ 0.5 mm [18]. Patients with a CRM of 0 or between 0.1 and 1 mm had a similar prognosis [18,20]. Both of these studies were relatively small and there was little information as to how exactly the CRM was measured.…”

Reply to Wang and Kan

“…Indeed, patients with a circumferential resection margin (CRM) of ≤ 0.4 mm are more likely to develop locoregional recurrence, leading to a reduced disease‐free survival, compared with patients with a CRM of 0.4 to ≤ 1 mm and with R0 patients, who have similar long‐term outcomes. To our knowledge, only two studies have evaluated the prognosis of patients after R1 resection specifically looking at CRM involvement . However, both studies compared only two relatively small groups of patients with CRM ≤ 1 mm.…”