Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer
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2019, Seminars in Colon and Rectal SurgeryThe technical aspects of rectal cancer surgery
2019, Seminars in Colon and Rectal SurgeryCitation Excerpt :In conclusion, while a 5 cm distal margin is preferred for more proximal tumors, patients with low rectal cancer tumors can achieve acceptable oncologic outcomes with a distal margin of 1 cm in the setting of multimodal therapy. In addition to proximal and distal margins, the circumferential resection margin (CRM) is an important prognostic indicator in rectal cancer surgery, serving as an independent determinant of local recurrence and overall survival.8,9 In the MERCURY trial, rectal cancer patients underwent preoperative high-resolution MRI to assess potential CRM involvement.
Reprint of: Important imaging considerations in the pre-operative assessment of rectal cancer
2018, Seminars in Colon and Rectal SurgeryCitation Excerpt :One of the key components of the staging classification is the depth of tumour invasion in relation to the bowel wall. Depth of extramural invasion is recognised as an independent prognostic factor.35,36 More recently, certain groups of patients have been identified who are considered high risk and thus may benefit from neo-adjuvant therapy, leading to a sub-classification of T-stage.
A meta-analysis assessing the survival implications of subclassifying T3 rectal tumours
2018, European Journal of CancerCitation Excerpt :AJCC staging manuals regard T3 tumours as a single group and define them as invasion of tumour through the muscularis propria into the subserosa, non-peritonealised pericolic or perirectal tissues. In 1993, the supplement to the 4th edition of the TNM manual proposed an optional tumour subclassification because of reports of better prognosis in more invasive T3 tumours; however, this has not been adopted [8,9]. This subclassification was dependent on invasion beyond the muscularis propria and was divided into four groups: T3a (<1 mm), T3b (1–5 mm), T3c (5–15 mm) and T3d (>15 mm).