Simple criteria to predict margin involvement after chemoradiotherapy and sphincter-sparing for low rectal cancer

International evaluation of circumferential resection margins after rectal cancer resection: insights from the Swedish and Dutch audits

“…Decisions for referral are often based on the response to preoperative treatment. Dumont et al showed that a residual tumour greater than 3 cm and tumour fixity are predictive of CRM+ [21]. However, one might argue that every locally advanced tumour should probably be referred from the start of treatment to a specialized centre.…”

“…In the international literature, a wide range of categories are used for rectal cancer volume at hospital level. Van Gijn et al calculated median cut-off points from published rectal cancer hospital volume studies, leading to a definition of a high-volume hospital a performing more than 24 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) rectal cancer resections per year and low-volume hospitals performing 9 (6-14) [28]. This hampers interpretation of the available literature on this topic.…”

“…The CRM was measured by pathologists using a standardized pathological assessment as introduced during the TME trial in both countries [15]. For hospital volume, cut-off points were used as described in the SCRCR National Quality Report 2016: very low volume (< 12 resections per year), low volume (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) resections per year), medium volume (26-50 resections per year) and high volume (> 50 resections per year) [16]. Additional analyses were performed using previously published cut-offs in DCRA analyses (< 20, 20-40, > 40) [17].…”