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Erschienen in: Annals of Surgical Oncology 3/2008

01.03.2008 | Gastrointestinal Oncology

Factors Influencing Pathologic Results after Total Mesorectal Excision for Rectal Cancer: Analysis of Consecutive 100 Cases

verfasst von: Seung Hyuk Baik, M.D., Nam Kyu Kim, M.D., Kang Young Lee, M.D., Seung Kook Sohn, M.D., Chang Hwan Cho, M.D., Myeong Jin Kim, M.D., Hogeun Kim, M.D., Rina K Shinn, M.D.

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2008

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Abstract

Background

The aim of this study was to analyze clinical and anatomical factors affecting the pathologic quality of the resected specimen after total mesorectal excision (TME) for rectal cancer.

Methods

A total of 100 patients who underwent TME for mid or low rectal cancer were evaluated prospectively. MRI pelvimetry data (transverse diameter, obstetric conjugate, interspinous distance, sacrum length, and sacrum depth) were analyzed as anatomically affecting factors to postoperative specimen quality. Sex, body mass index (BMI), type of surgery, tumor size, and tumor distance from the anal verge were analyzed as clinically affecting factors. The gross judgment of resected specimen, circumferential resection margin and the number of harvested lymph nodes were used to access postoperative specimen quality.

Results

The univariate and multivariate analysis showed that narrow obstetric conjugate and shorter interspinous distance were related to the inadequate quality of the mesorectum in the specimen (P = 0.022, P = 0.030). Interspinous distance was a predicting factor of a positive circumferential resection margin (P = 0.007). There were no clinical factors affecting the inadequate quality of the mesorectum or positive circumferential resection margin. Moreover, there were no clinico-anatomical factors affecting the number of harvested lymph nodes after TME.

Conclusion

Narrow obstetric conjugate and shorter interspinous distance were factors leading to poor postoperative specimen quality. Rectal cancer patients with narrow obstetric conjugate or shorter interspinous distance should be considered as high-risk patients with regard to specimen quality, which is in turn related to oncological outcome.
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Metadaten
Titel
Factors Influencing Pathologic Results after Total Mesorectal Excision for Rectal Cancer: Analysis of Consecutive 100 Cases
verfasst von
Seung Hyuk Baik, M.D.
Nam Kyu Kim, M.D.
Kang Young Lee, M.D.
Seung Kook Sohn, M.D.
Chang Hwan Cho, M.D.
Myeong Jin Kim, M.D.
Hogeun Kim, M.D.
Rina K Shinn, M.D.
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 3/2008
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9706-z

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