Intra-operative resection margin model of tongue carcinoma using 3D reconstructed ultrasound.

Purpose Current adjuvant therapies for pancreatic cancer (PC) are inconsistently used and only modestly effective. Because a high proportion of patients who undergo resection for PC likely harbor occult metastatic disease, any adjuvant trials assessing therapies such as radiotherapy directed at locoregional disease are significantly underpowered. Stratification based on the probability (and volume) of residual locoregional disease could play an important role in the design of future clinical trials assessing adjuvant radiotherapy. Patients and Methods We assessed the relationships between margin involvement, the proximity to operative resection margins and outcome in a cohort of 365 patients who underwent operative resection for PC. Results Microscopic involvement of a resection margin by tumor was associated with a poor prognosis. Stratifying the minimum clearance of resection margins by 0.5-mm increments demonstrated that although median survival was no different to clear margins based on these definitions, it was not until the resection margin was clear by more than 1.5 mm that optimal long-term survival was achieved. Conclusion These data demonstrate that a margin clearance of more than 1.5 mm is important for long-term survival in a subgroup of patients. More aggressive therapeutic approaches that target locoregional disease such as radiotherapy may be beneficial in patients with close surgical margins. Stratification of patients for entry onto future clinical trials based on this criterion may identify those patients who benefit from adjuvant radiotherapy.

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Towards intra-operative resection margin assessment using near infrared hyperspectral imaging in squamous cell carcinoma of the tongue

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.10.108 ◽

2019 ◽

Vol 45 (2) ◽

pp. e2-e3

Author(s):

S. Brouwer De Koning ◽

B. Karakullukcu ◽

L. Smit ◽

L. Baltussen ◽

H. Sterenborg ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Hyperspectral Imaging ◽

Squamous Cell ◽

Near Infrared ◽

Resection Margin ◽

Margin Assessment ◽

Operative Resection ◽

Carcinoma Of The Tongue

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NOVEL METHOD TO ASSESS COLD SNARE POLYPECTOMY QUALITY FOR 1-10 MM COLORECTAL POLYPS - MEASURING THE MINIMUM EXTENT OF A HEALTHY RESECTION MARGIN

10.1055/s-0040-1704203 ◽

2020 ◽

Author(s):

H Pohl ◽

D von Renteln ◽

A Aguilera-Fish ◽

JC Anderson

Keyword(s):

Resection Margin ◽

Colorectal Polyps ◽

Cold Snare Polypectomy ◽

Novel Method ◽

Snare Polypectomy

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Is a Short Distal Resection Margin of Less than One Centimeter in a Sphincter-saving Resection for Rectal Cancer Oncologically Safe?

Journal of the Korean Society of Coloproctology ◽

10.3393/jksc.2007.23.6.454 ◽

2007 ◽

Vol 23 (6) ◽

pp. 454

Author(s):

Min Jeong Cho ◽

Chang Sik Yu ◽

In Ja Park ◽

Sang Hoon Jeong ◽

Pheung Ha Chae ◽

...

Keyword(s):

Rectal Cancer ◽

Resection Margin ◽

Distal Resection Margin ◽

Sphincter Saving Resection ◽

Sphincter Saving

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Salivary gland carcinoma (SGC) with perineural spread and/or positive resection margin – high locoregional control rates after photon (chemo) radiotherapy - experience from a monocentric analysis

Radiation Oncology ◽

10.1186/s13014-019-1260-x ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Marlen Haderlein ◽

Claudia Scherl ◽

Sabine Semrau ◽

Sebastian Lettmaier ◽

Markus Hecht ◽

...

Keyword(s):

Salivary Gland ◽

Resection Margin ◽

Locoregional Control ◽

Salivary Gland Carcinoma ◽

Positive Resection Margin ◽

Perineural Spread ◽

Gland Carcinoma

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The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02223-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

I-Li Lai ◽

Jeng-Fu You ◽

Yih-Jong Chern ◽

Wen-Sy Tsai ◽

Jy-Ming Chiang ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Local Recurrence ◽

Distant Metastasis ◽

Resection Margin ◽

Radical Resection ◽

Hazard Ratio ◽

Low Rectal Cancer ◽

Distal Resection Margin ◽

Lymph Node Yield

Abstract Background Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. Methods This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. Results The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. Conclusion For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research.

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Pattern and localization of perineural invasion predict poor survival in oral tongue carcinoma

Oral Diseases ◽

10.1111/odi.13900 ◽

2021 ◽

Author(s):

Vito Carlo Alberto Caponio ◽

Giuseppe Troiano ◽

Lucrezia Togni ◽

Khrystyna Zhurakivska ◽

Andrea Santarelli ◽

...

Keyword(s):

Perineural Invasion ◽

Tongue Carcinoma ◽

Oral Tongue ◽

Poor Survival

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Multimodal Treatment of cT3 Rectal Cancer in a Prospective Multi-Center Observational Study: Can Neoadjuvant Chemoradiation Be Omitted in Patients with an MRI-Assessed, Negative Circumferential Resection Margin?

Visceral Medicine ◽

10.1159/000514800 ◽

2021 ◽

pp. 1-8

Author(s):

Henry Ptok ◽

Frank Meyer ◽

Ingo Gastinger ◽

Benjamin Garlipp

Keyword(s):

Rectal Cancer ◽

Observational Study ◽

Circumferential Resection Margin ◽

Resection Margin ◽

Anal Verge ◽

Final Analysis ◽

Radical Resection ◽

Distant Recurrence ◽

Neoadjuvant Chemoradiation ◽

Recurrence Rates

Background/Aim: Neoadjuvant chemoradiation (nCRT) in rectal cancer is associated with significant long-term morbidity. It is unclear whether nCRT in resectable mesorectal fascia circumferential resection margin (mrCRM)-negative rectal cancer treated by adequate total mesorectal excision (TME) is beneficial. The aim was to determine if nCRT can be omitted in patients with MRI-assessed cT3 rectal cancer and a negative mrCRM undergoing good-quality TME. Methods: By means of a prospective nationwide registry (n = 43.147; prospective multi-center observational study), patients with cT3 rectal cancer <12 cm from the anal verge with a negative (>1 mm) MRI-assessed CRM undergoing radical resection from 2006 to 2008 were selected. Overall, 87 patients were available for the final analysis (TME-alone, n = 25; nCRT+TME, n = 62). Groups were balanced for age, sex, and ASA score, with a nonsignificant predominance of males in the nCRT+TME group. As main outcome measures, local and distant recurrence rates were compared between patients undergoing primary surgery (TME-alone) vs. neoadjuvant chemoradiation + surgery (nCRT+TME). Results: In the TME-alone group, tumors were located closer to the anal verge (p = 0.018) and demonstrated a smaller minimal circumferential distance from the resection margin (p = 0.036). TME quality was comparable, as was median follow-up (48.9 vs. 44.9 months; p = 0.268). Local recurrences occurred at a similar rate in the TME-alone (n = 1; 5.3%) and nCRT+TME groups (n = 3; 5.5%) (p = 0.994) and were diagnosed at 10 months (TME-alone) and at 8, 13, and 18 months (nCRT+TME). Distant recurrences occurred in 28.9 and 17.4% of the cases, respectively (p = 0.626). The analysis was limited to cT3 cancers with a negative mrCRM. In addition, caution is required when appraising these results because of the limited number of evaluable subjects (especially in the TME-alone group), which adds some uncertainty to the statistical analysis. Conclusions: In this cohort of patients with rectal cancer located <12 cm from the anal verge and a negative mrCRM undergoing adequate TME, omission of nCRT had no impact onto the local recurrence rate.

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