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Predictors of Positive Radial Margin Status in a Population Based Cohort of Patients with Rectal Cancer
Abstract
Background: Surgical margin status is an important predictor of risk of relapse among patients with rectal cancer.
Methods: Patients referred to the British Columbia Cancer Agency for consideration of adjuvant therapy for rectal adenocarcinoma were included. Predictors of margin positivity were determined from uni-and multivariate analysis.
Results: Of 340 patients, 83% had negative resection margins. In 268 patients with resectable tumors, a significantly higher rate of margin positivity was observed in low rectal tumors (32.2%), compared to mid (3.9%) and high (14.3%) tumors. Among 59 patients with locally advanced rectal cancer treated with pre-operative radiation (+/- chemotherapy), the margin positivity was 32% among those with low tumors. 50% (11/22) of patients with T4 tumors had a positive resection margin.
Conclusions: In a population cohort, distal third rectal location, locally advanced presentation, and T4 cancers represent subgroups where further improvement in therapy is required.
Methods: Patients referred to the British Columbia Cancer Agency for consideration of adjuvant therapy for rectal adenocarcinoma were included. Predictors of margin positivity were determined from uni-and multivariate analysis.
Results: Of 340 patients, 83% had negative resection margins. In 268 patients with resectable tumors, a significantly higher rate of margin positivity was observed in low rectal tumors (32.2%), compared to mid (3.9%) and high (14.3%) tumors. Among 59 patients with locally advanced rectal cancer treated with pre-operative radiation (+/- chemotherapy), the margin positivity was 32% among those with low tumors. 50% (11/22) of patients with T4 tumors had a positive resection margin.
Conclusions: In a population cohort, distal third rectal location, locally advanced presentation, and T4 cancers represent subgroups where further improvement in therapy is required.