Is There an Optimal Definition for a Positive Circumferential Resection Margin in Locally Advanced Esophageal Cancer?
| Autor: | Clarisse Eveno, Florence Renaud, Christophe Mariette, Hélène Behal, Emmanuelle Leteurtre, Guillaume Piessen, B. Brac, Charlotte Dufour, M. Vanderbeken, Julien Labreuche |
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| Přispěvatelé: | Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Hôpital Claude Huriez [Lille], CHU Lille, Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Department of Digestive and Oncological Surgery [Lille], CHU Lille-CHU Lille-Université de Lille |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
animal structures Multivariate analysis Esophageal Neoplasms [SDV]Life Sciences [q-bio] Locally advanced Surgical oncology medicine Humans Cutoff Neoplasm Staging Retrospective Studies integumentary system Rectal Neoplasms business.industry fungi Hazard ratio Margins of Excision food and beverages Esophageal cancer Prognosis medicine.disease Esophagectomy Oncology embryonic structures Resection margin Adenocarcinoma Surgery Radiology Neoplasm Recurrence Local business |
| Zdroj: | Annals of Surgical Oncology Annals of Surgical Oncology, 2021, 28 (13), pp.8337-8346. ⟨10.1245/s10434-021-10707-6⟩ |
| ISSN: | 1534-4681 1068-9265 |
| Popis: | International audience; Background: Two definitions of a positive circumferential resection margin (CRM) in esophageal cancer coexist: one by the College of American Pathologists (CAP) (CRM = 0 mm) and another by the Royal College of Pathologists (RCP) (CRM = pT3) adenocarcinoma or squamous cell carcinoma were selected from 2007 to 2016. The CRM was reassessed using an ocular micrometer. Overall survival (OS) and disease-free survival were estimated with uni- and multivariate analyses. Results The study enrolled 283 patients: 48 with a positive CRM according to the CAP definition and 171 with a positive CRM according to the RCP definition. In the multivariate analysis, a positive CRM according to both definitions was significantly associated with a poor OS (CAP: hazard ratio [HR], 2.26, p < 0.001; RCP: HR, 1.42, p = 0.035). A CRM of 0 mm was predictive of a worse OS and DFS than a CRM of 1 mm or less (p < 0.0001), whereas no significant difference was found between a CRM greater than 1 mm and a CRM of 1 mm or less, indicating that the CAP definition was more accurate for predicting prognosis and recurrence. New cutoff CRM values of 100 mu m in squamous cell carcinoma and 200 mu m in adenocarcinoma were optimal for predicting OS. Conclusion The CAP definition was more accurate for predicting prognosis and recurrence. The study identified a new cutoff value of CRM according to histologic type. |
| Databáze: | OpenAIRE |
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