Retroperitoneal margin involvement by adenocarcinoma of the caecum and ascending colon: what does it mean?

Scott, Nigel; Jamali, Ailar; Verbeke, Caroline; Ambrose, N. S.; Botterill, I. D.; Jayne, David

doi:10.1111/j.1463-1318.2007.01365.x

Cited by 33 publications

(22 citation statements)

References 11 publications

(16 reference statements)

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“…The resection rate was high (82.8%) indicating an aggressive surgical approach. When considering patients without metastatic disease having an elective resection undertaken with curative intent then the R1 rate was 8.3%, in keeping with the results from other smaller series [5][6][7] of right sided resection.…”

Section: Discussionsupporting

confidence: 76%

“…This is the largest sequential single centre series looking at R1 resection after colon cancer surgery in the literature. There are three previous studies of resection margin involvement reporting posterior retroperitoneal surgical resection margin in right hemicolectomy [5][6][7]. Amongst these, the study by Quirke et al [6] was published as an abstract only and there is little in the literature regarding left sided colonic resection.…”

Section: Discussionmentioning

confidence: 99%

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Significance of R1 resection margin in colon cancer resections in the modern era

Khan¹,

Hakeem²,

Scott

et al. 2015

Colorectal Disease

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Significance of R1 resection margin in colon cancer resections in the modern era

Khan¹,

Hakeem²,

Scott

et al. 2015

Colorectal Disease

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“…More recently, similar findings were reported in colonic cancer, especially the right side [155,156]. …”

Section: Resection Marginssupporting

confidence: 84%

Review of Histopathological and Molecular Prognostic Features in Colorectal Cancer

Marzouk

Schofield

2011

Cancers

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Prediction of prognosis in colorectal cancer is vital for the choice of therapeutic options. Histopathological factors remain paramount in this respect. Factors such as tumor size, histological type and subtype, presence of signet ring morphology and the degree of differentiation as well as the presence of lymphovascular invasion and lymph node involvement are well known factors that influence outcome. Our understanding of these factors has improved in the past few years with factors such as tumor budding, lymphocytic infiltration being recognized as important. Likewise the prognostic significance of resection margins, particularly circumferential margins has been appreciated in the last two decades. A number of molecular and genetic markers such as KRAS, BRAF and microsatellite instability are also important and correlate with histological features in some patients. This review summarizes our current understanding of the main histopathological factors that affect prognosis of colorectal cancer.

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“…[21][22][23] In addition to extensive surgery, neoadjuvant therapies could optimize R0 resection proportions in LACC. 24,25 In contrast to other types of gastrointestinal cancer, administration of neoadjuvant therapy in colon cancer remains uncommon. 11,14,26,27 Incidental use of a variety of neoadjuvant therapy schedules has been described.…”

Section: Discussionmentioning

confidence: 99%

Locally Advanced Colon Cancer: Evaluation of Current Clinical Practice and Treatment Outcomes at the Population Level

Klaver

Gietelink

Bemelman

et al. 2017

J Natl Compr Canc Netw

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The goal of this study was to evaluate current clinical practice and treatment outcomes regarding locally advanced colon cancer (LACC) at the population level. Data were used from the Dutch Surgical Colorectal Audit from 2009 to 2014. A total of 34,527 patients underwent resection for non-LACC and 6,918 for LACC, which was defined as cT4 and/or pT4 stage. LACC was divided into those with multivisceral resection (LACC-MV; n=3,385) and without (LACC-noMV; n=1,595). Guideline adherence, treatment strategy, and short-term outcomes were evaluated. Guideline adherence was >90% regarding preoperative imaging and ≥80% regarding preoperative multidisciplinary team (MDT) discussion. In the elective setting, neoadjuvant chemoradiotherapy (chemoRT) was applied in 6.2% of the cT4 cases, and neoadjuvant chemotherapy in 4.0%. R0 resection rates were 99%, 91%, and 87% in patients with non-LACC, LACC-noMV, and LACC-MV, respectively (<.001). A postoperative complicated course occurred in 17%, 25%, and 29% of patients (<.001), and the 30-day/in-hospital mortality rate was 3.6%, 6.0%, and 5.4% (<.001) in the non-LACC, LACC-noMV, and LACC-MV groups, respectively. This population-based study suggests that there is room for improvement in the treatment of LACC, with regard to short-term surgical outcomes and oncologic outcomes (ie, radicality of resection). Improvement might be expected from optimized preoperative imaging, routine MDT discussions, and further specialization and centralization of care. Optimized use of neoadjuvant treatment strategies based on already available and upcoming evidence is likely to result in a better margin status and thereby a better long-term prognosis. Furthermore, lower R0 resection rates in an emergency setting suggest a potential role for bridging strategies in order to enable optimal staging, neoadjuvant treatment, and elective surgery by a surgical team most optimally qualified for the procedure.

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Retroperitoneal margin involvement by adenocarcinoma of the caecum and ascending colon: what does it mean?

Cited by 33 publications

References 11 publications

Significance of R1 resection margin in colon cancer resections in the modern era

Significance of R1 resection margin in colon cancer resections in the modern era

Review of Histopathological and Molecular Prognostic Features in Colorectal Cancer

Locally Advanced Colon Cancer: Evaluation of Current Clinical Practice and Treatment Outcomes at the Population Level

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