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Indian Journal of Surgical Oncology
Erschienen in: Indian Journal of Surgical Oncology 4/2022

16.06.2022 | Review Article

The Impact of Narrow and Infiltrated Distal Margin After Proctectomy for Rectal Cancer on Patients’ Outcomes: a Systematic Review and Meta-analysis

verfasst von: Islam H. Metwally, Mohammad Zuhdy, Omar Hamdy, Ahmed M. Fareed, Saleh S. Elbalka

Erschienen in: Indian Journal of Surgical Oncology | Ausgabe 4/2022

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Abstract

Rectal cancer is a common tumor within a difficult anatomic constraint. Total mesorectal excision with longitudinal and circumferential free margins is considered imperative for good prognosis. In this article, the authors systematically reviewed all published literature with specific Mesh terms until the end of year 2019. Thereafter, retrieved articles were assessed using the Newcastle–Ottawa Scale and meta-analysis was conducted comparing local recurrence among 1-cm, 5-mm, and narrow (< 1-mm)/infiltrated margins. Thirty-nine articles were included in the study. Macroscopic distal margin < 1 cm carried a higher incidence of recurrence for those who did not receive neoadjuvant radiation, without affecting neither estimated overall nor disease-free survival. Less than 5-mm margin after radiation therapy is accepted oncologically. Infiltrated margins and narrow margins (< 1 mm) microscopically are associated with higher incidence of local recurrence and shorter overall and disease-free survival. Surgeons should aim at 1-cm safety margin in radiotherapy-naïve patients and microscopic free margin > 1 mm for those who received neoadjuvant therapy. The cost/benefit of reoperation for patients with infiltrated margins is still inadequately studied.
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Metadaten
Titel
The Impact of Narrow and Infiltrated Distal Margin After Proctectomy for Rectal Cancer on Patients’ Outcomes: a Systematic Review and Meta-analysis
verfasst von
Islam H. Metwally
Mohammad Zuhdy
Omar Hamdy
Ahmed M. Fareed
Saleh S. Elbalka
Publikationsdatum
16.06.2022
Verlag
Springer India
Erschienen in
Indian Journal of Surgical Oncology / Ausgabe 4/2022
Print ISSN: 0975-7651
Elektronische ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-022-01565-z

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