Clinicopathological factors associated with positive circumferential margins in rectal cancers
| Autor: | Lachlan B. Pasch, Walid Barto, Toufic El Khoury, Krishna Kotecha, James A. Pasch, Chatika Premaratne, Ewan MacDermid, Kar Yin Fok |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Colorectal cancer medicine.medical_treatment Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Adjuvant therapy Humans Medicine Stage (cooking) Aged Neoplasm Staging Retrospective Studies Aged 80 and over Univariate analysis Rectal Neoplasms business.industry Carcinoma Margins of Excision General Medicine Odds ratio Middle Aged medicine.disease Survival Rate Radiation therapy Logistic Models Treatment Outcome 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Histopathology New South Wales business |
| Zdroj: | ANZ Journal of Surgery. 89:1636-1641 |
| ISSN: | 1445-2197 1445-1433 |
| DOI: | 10.1111/ans.15418 |
| Popis: | BACKGROUND Positive circumferential resections are associated with local disease recurrence and reduced survival in rectal cancer. We studied a cohort of consecutive rectal cancer resections to assess for clinicopathological differences and survival in patients with positive and negative circumferential margins. METHODS Rectal cancers were identified from a retrospective histopathology database of colorectal resections performed at five western Sydney hospitals from 2010 to 2016. Univariate and multivariate analysis with binary logistic regression were performed on histopathology data matched with survival times from the New South Wales Registry of Births Deaths and Marriages. RESULTS A total of 502 rectal cancer patients were identified including 66 (13.1%) with involved circumferential margins. Patients with positive and negative circumferential margins had a similar distribution of age, gender and use of neoadjuvant radiotherapy. Tumours with involved circumferential margin comprised 98.5% T3 and T4 disease of which 51.5% received neoadjuvant radiotherapy. These were significantly associated with metastatic disease, increasing tumour size, circumferential and perforated tumours on univariate analysis. Multivariate analysis identified abdomino-perineal resection (odds ratio (OR) 3.35; P = 0.003), en-bloc multivisceral resection (OR 2.56; P = 0.032), T4 stage (OR 6.99; P |
| Databáze: | OpenAIRE |
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