The Influence of Circumferential Resection Margin Status on Loco-regional Recurrence in Esophageal Squamous Cell Carcinoma

Park, H.; Kim, Ha Yong; Chie, Eui Kyu; Kim, Y.; Kang, Chang Hyun

doi:10.1016/j.ijrobp.2012.07.798

Cited by 2 publications

(6 citation statements)

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“…In the first study of CRM involvement by Sagar et al [25], significantly (p < 0.01) more patients with a positive CRM (55%) developed a local recurrence as compared to those without involvement of the CRM (13%) [25]. These results were later proven by other studies, which also identified a prognostic role of a positive CRM on recurrences [3,13,14,17,18,22,26]. Chao et al [26] found a significant influence of an involved CRM not only on loco-regional but also on distant recurrences, while an involvement to the CRM of less than 1 mm was associated with early loco-regional recurrences.…”

Section: Recurrencementioning

confidence: 87%

“…Especially for EC, the data are very heterogenic, and interpretation is hampered by several factors. In the reviewed literature, a wide range of CRM involvement (8.6-83.1%) has been reported [3,22]. The difference can be explained by the varying pathologic classification systems (RCP and CAP criteria; Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Only patients with a positive CRM and pN2-3 stage yielded a benefit from this treatment in regards to loco-regional recurrences. However, the latter finding failed to reached statistical significance (p = 0.057) [22].…”

Section: Adjuvant Therapymentioning

confidence: 93%

“…Despite advances in surgical techniques local, regional and distant recurrences frequently occur after resection [24]. Loco-regional recurrences seem to be the predominant failure pattern in CRM positive patients [22]. In the first study of CRM involvement by Sagar et al [25], significantly (p < 0.01) more patients with a positive CRM (55%) developed a local recurrence as compared to those without involvement of the CRM (13%) [25].…”

Section: Recurrencementioning

confidence: 99%

“…Park et al [22] investigated the effect of postoperative radiotherapy in esophageal squamous cell carcinomas (ESCC) only. They were not able to demonstrate a significant survival benefit between patients with positive or negative CRM (p = 0.883) treated with adjuvant radiotherapy.…”

Section: Adjuvant Therapymentioning

confidence: 99%

See 4 more Smart Citations

Does the Margin Matter in Esophageal Cancer

Karstens

Izbicki²,

Reeh³

2017

Dig Surg

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Background: The prognostic impact of circumferential resection margin (CRM) involvement in resected esophageal cancer (EC) is controversial discussed. The College of American Pathologists (CAP) and the Royal College of Pathologists (RCP) provide 2 different definitions of CRM involvement. The aim of this systematic review was to evaluate the clinical significance of CRM involvement on patients' survival following esophagectomy due to EC. Methods: PubMed, Science Direct, and Google scholar were searched for studies analyzing the clinical impact of CRM in EC. Summary: A total of 28 studies analyzed the prognostic effect of a positive CRM in EC. A wide range of CRM involvement (8.6-83.1%) was reported. Both available meta-analyses found a significant association between a positive CRM and patients' survival irrespective of RCP (OR 2.52 [95% CI 1.96-3.25; p < 0.001]) or CAP (OR 4.02 [95% CI 2.25-7.20; p < 0.001]) criteria. The influence of neoadjuvant therapy on the CRM remains unclear. Key Messages: CRM involvement is a useful parameter for EC patients' prognosis. The application of CAP criteria should be preferred since patients with a poor prognosis can be identified more sufficiently. Neoadjuvant therapy and en bloc transthoracic esophagectomy show favorable results for achievement of negative CRM.

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