Association Between a Close Distal Resection Margin and Recurrence After a Sphincter-Saving Resection for T3 Mid- or Low-Rectal Cancer Without Radiotherapy

• Published in: Annals of coloproctology Vol. 29; no. 6; pp. 231 - 237
• Main Authors: Han, Jae Woong, Lee, Min Jae, Park, Ha Kyung, Shin, Jae Ho, An, Min Sung, Ha, Tae Kwun, Kim, Kwang Hee, Bae, Ki Beom, Kim, Tae Hyun, Choi, Chang Soo, Oh, Sang Hoon, Oh, Min Kyung, Kang, Mi Seon, Hong, Kwan Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Coloproctology 01.12.2013; 대한대장항문학회
• Subjects: Original; 일반외과학; Rectal neoplasms; Recurrence; Distal resection margin
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2013.29.6.231

To maintain the patient's quality of life, surgeons strive to preserve the sphincter during rectal cancer surgery. This study evaluated the oncologic safety of a sphincter-saving resection with a distal resection margin (DRM) <1 cm without radiotherapy in T3, mid- or low-rectal cancer. This retrospective study enrolled 327 patients who underwent a sphincter-saving resection for proven T3 rectal cancer located <10 cm from the anal verge and without radiotherapy between January 1995 and December 2011. The oncologic outcomes included the 5-year cancer-specific survival, the local recurrence, and the systemic recurrence rates. In groups A (DRM ≤1 cm) and B (DRM >1 cm), the 5-year cancer-specific survival rates were 81.57% and 80.03% (P = 0.8543), the 5-year local recurrence rates were 6.69% and 9.52% (P = 0.3981), and the 5-year systemic recurrence rates were 19.46% and 23.11% (P = 0.5750), respectively. This study showed that the close DRM itself should not be a contraindication for a sphincter-saving resection for T3 mid- or low-rectal cancer without radiotherapy. However, a prospective randomized controlled trial including the effect of adjuvant therapy will be needed.