Mesorectal Grades Predict Recurrences After Curative Resection for Rectal Cancer
| Autor: | John R. T. Monson, Sushil Maslekar, J. E. Hartley, Abhiram Sharma, James Gunn, Alistair MacDonald |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Rectum Mesorectum Adenocarcinoma Predictive Value of Tests medicine Adjuvant therapy Humans Prospective Studies Grading (tumors) Digestive System Surgical Procedures Aged Neoplasm Staging Proportional Hazards Models Mesorectal Aged 80 and over Rectal Neoplasms business.industry Gastroenterology General Medicine Middle Aged Magnetic Resonance Imaging Survival Analysis Total mesorectal excision Colorectal surgery Surgery Treatment Outcome medicine.anatomical_structure Predictive value of tests Female Neoplasm Recurrence Local business |
| Zdroj: | Diseases of the Colon & Rectum. 50:168-175 |
| ISSN: | 0012-3706 |
| Popis: | Local recurrence after curative excision for rectal cancer is frequently regarded as a failure of surgery. The macroscopic quality of the excised mesorectum after total mesorectal excision has been proposed as a means of assessment of the adequacy of surgery. This study was designed to determine the utility of mesorectal grading in prediction of local and overall recurrence after curative surgery. All patients undergoing resection for primary adenocarcinoma of the rectum had a mesorectal grading prospectively applied to their resection specimens, according to the classification proposed by Quirke et al. (Grades 1–3; 3 is the best). The outcome of patients undergoing potentially curative surgery from 2001 to 2003 was reviewed. Prognostic significance of mesorectal grades was determined by multivariate regression analyses. A total of 130 patients with a median follow-up of 26 (range, 17–42) months were studied. The local and overall recurrences were 8.4 and 15 percent, respectively. The mesorectum was reported as Grade 3 in 61 patients (47 percent), Grade 2 in 52 patients (40 percent), and Grade 1 in 17 patients (13 percent). Patients with Grade 1 mesorectum had 41 percent local recurrence and 59 percent overall recurrence, respectively. However, patients with Grade 2 and Grade 3 mesorectum had 5.7 and 1.6 percent local recurrences, respectively, and 17 and 1.6 percent overall recurrence, respectively. By Cox’s regression analysis, grade of mesorectum independently influenced both local and overall recurrences. The macroscopic quality of mesorectum after curative excision of rectal cancer is an important predictor of local and overall recurrences. The mesorectal grades may be of value in decisions regarding postoperative adjuvant therapy. |
| Databáze: | OpenAIRE |
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