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Distal clearance margin of 1 cm or less: a safe distance in lower rectum cancer surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to investigate the prognostic role of distal clearance margin (DCM) in lower rectum cancer surgery.

Materials and methods

Two-hundred-three cancer patients underwent total rectal resection, possibly followed by adjuvant chemoradiotherapy. DCM was classified as positive or negative (<1, ≥1 cm) and investigated with multivariable proportional hazard models.

Results

A total of 52 deaths, 19 local relapses, 40 distant metastases, and three second primaries were observed as first events. Five-year survival with positive, negative <1, or negative ≥1 cm DCM was 51%, 81%, and 69%, respectively (p = 0.018). The difference was significant between positive and negative DCM (p = 0.031), not between negative <1 and ≥1 cm (p = 0.106). Local and distant 5-year incidences according to DCM were 30%, 8%, and 8% (p = 0.006) and 38%, 26%, and 19% (p = 0.857), respectively.

Conclusions

DCM, but not tumor size, is a prognostic factor after sphincter-saving surgery, which is safe whenever a negative margin is achieved.

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Acknowledgments

This study was partially supported by the Italian Association for Cancer Research.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Ermanno Leo, Filiberto Belli, GianFrancesco Gallino, Luigi Battaglia & Alberto Vannelli

  2. Division of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Rosalba Miceli & Luigi Mariani

  3. Division of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Salvatore Andreola

  4. Colorectal Surgery, Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Filiberto Belli

Authors
  1. Ermanno Leo
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  2. Filiberto Belli
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  3. Rosalba Miceli
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  4. Luigi Mariani
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  5. GianFrancesco Gallino
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  6. Luigi Battaglia
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  7. Alberto Vannelli
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  8. Salvatore Andreola
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Corresponding author

Correspondence to Filiberto Belli.

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Leo, E., Belli, F., Miceli, R. et al. Distal clearance margin of 1 cm or less: a safe distance in lower rectum cancer surgery. Int J Colorectal Dis 24, 317–322 (2009). https://doi.org/10.1007/s00384-008-0604-z

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  • DOI: https://doi.org/10.1007/s00384-008-0604-z

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