Erschienen in:
18.03.2019 | Editorial
The influence of metastatic lymph nodes at the circumferential resection margin of rectal cancer—Do these lymph nodes require any special attention?
verfasst von:
G. P. São Julião, R. O. Perez
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 2/2019
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Excerpt
The improvement in rectal cancer care has led to a marked reduction in local recurrence rates. Implementation of neoadjuvant treatment strategies, improved radiological loco-regional staging with magnetic resonance, and precise total mesorectal excision are key features to determine optimal local control for this disease. In this setting, the most significant predictor of local recurrence is circumferential resection margin (CRM) status at the resected specimen. A positive pathological CRM (CRM+) increases significantly the rates of local recurrence, overriding any other patient, tumor, or treatment risk factor. Therefore, all attempts should be directed to identifying patients at risk. This could provide the first step in avoiding this unfavorable surgical outcome. …