Skip to main content
Journal cover image

Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient?

Publication ,  Journal Article
Kuvshinoff, B; Maghfoor, I; Miedema, B; Bryer, M; Westgate, S; Wilkes, J; Ota, D
Published in: Ann Surg Oncol
March 2001

BACKGROUND: Sphincter-sparing alternatives to abdominoperineal resection (APR) in the treatment of rectal cancer often are underused out of concern for inadequate distal margins and local failure. The present study addresses whether sphincter-sparing techniques with distal margins < or = 1 cm adversely influence oncological outcome in patients given preoperative chemoradiotherapy. METHODS: Thirty-seven patients with rectal cancer < or = 8 cm from the anal verge were enrolled in the study. Preoperative external beam radiotherapy (5400 Gy) was administered together with continuous infusion of 5-fluorouracil (300 mg/m2/day). Surgical resection was performed in 36 patients with pathological assessment of tumor response and margins. Patients with sphincter-sparing resection and distal margins > 1 cm or < or = 1 cm and those who underwent APR were compared. RESULTS: Thirty-six patients completed preoperative chemoradiotherapy, with successful sphincter-preservation in 28 patients. At a median follow-up of 33 months, there were 12 recurrences overall, which included 11 distant failures and four pelvic failures. Disease-free survival (DFS) was not different between those who had an APR compared with sphincter-sparing resection with distal margins < or = 1 cm. DFS was worse (P < .02) when radial margins were < or = 3 mm compared with > 3 mm. CONCLUSIONS: Sphincter preservation is feasible in more than 75% of patients with tumors < or = 8 cm from the anal verge after preoperative chemoradiotherapy. Sphincter-sparing surgery with distal margins < or = 1 cm can be used without adversely influencing local recurrence or DFS. Limited radial margins (< or = 3 mm), however, are associated with increased disease recurrence.

Duke Scholars

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

March 2001

Volume

8

Issue

2

Start / End Page

163 / 169

Location

United States

Related Subject Headings

  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymph Node Excision
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kuvshinoff, B., Maghfoor, I., Miedema, B., Bryer, M., Westgate, S., Wilkes, J., & Ota, D. (2001). Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient? Ann Surg Oncol, 8(2), 163–169. https://doi.org/10.1007/s10434-001-0163-9
Kuvshinoff, B., I. Maghfoor, B. Miedema, M. Bryer, S. Westgate, J. Wilkes, and D. Ota. “Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient?Ann Surg Oncol 8, no. 2 (March 2001): 163–69. https://doi.org/10.1007/s10434-001-0163-9.
Kuvshinoff B, Maghfoor I, Miedema B, Bryer M, Westgate S, Wilkes J, et al. Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient? Ann Surg Oncol. 2001 Mar;8(2):163–9.
Kuvshinoff, B., et al. “Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient?Ann Surg Oncol, vol. 8, no. 2, Mar. 2001, pp. 163–69. Pubmed, doi:10.1007/s10434-001-0163-9.
Kuvshinoff B, Maghfoor I, Miedema B, Bryer M, Westgate S, Wilkes J, Ota D. Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient? Ann Surg Oncol. 2001 Mar;8(2):163–169.
Journal cover image

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

March 2001

Volume

8

Issue

2

Start / End Page

163 / 169

Location

United States

Related Subject Headings

  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymph Node Excision
  • Humans
  • Female