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

대한대장항문학회지 2013년 29권 6호 p.231 ~ 237
 ( Han Jae-Woong ) - Inje University College of Medicine Inje University Pusan Paik Hospital Department of Surgery

 ( Park Ha-Kyung ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Shin Jae-Ho ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( An Min-Sung ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Ha Tae-Kwun ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Kim Kwang-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Bae Ki-Beom ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Kim Tae-Hyun ) - Inje University College of Medicine Inje University Pusan Paik Hospital Department of Surgery
 ( Choi Chang-Soo ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Oh Sang-Hoon ) - Inje University College of Medicine Pusan Paik Hospital Department of Surgery
 ( Oh Min-Kyung ) - Inje University College of Medicine Clinical Trial Center in Pharmacology
 ( Kang Mi-Seon ) - Inje University College of Medicine Busan Paik Hospital Department of Pathology
 ( Hong Kwan-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery

Abstract


Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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

키워드

Rectal neoplasms; Distal resection margin; Recurrence
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