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Significance of Radial Margin in Patients Undergoing Complete Mesocolic Excision for Colon Cancer

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Title: Significance of Radial Margin in Patients Undergoing Complete Mesocolic Excision for Colon Cancer
Authors: Jong Min Lee, Kang Young Lee, Min Soo Cho, Ng Siu Man Simon, Byung Soh Min, Nam Kyu Kim, Ga Ram Kim, Yoon Dae Han, Taek Chung, Kyung Min Kim, Sat Byol Lee, Hyuk Hur
Contributors: Jong Min Lee, Taek Chung, Kyung Min Kim, Ng Siu Man Simon, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Sat Byol Lee, Ga Ram Kim, Byung Soh Min, Kim, Nam Kyu
Source: Diseases of the Colon & Rectum. 63:488-496
Publisher Information: Ovid Technologies (Wolters Kluwer Health), 2020.
Publication Year: 2020
Subject Terms: Male, Margins of Excision, Colonic Neoplasms / mortality, Adenocarcinoma, Colonic Neoplasms / surgery, Registries, Disease-Free Survival, Adenocarcinoma / mortality, Adenocarcinoma / diagnosis, 03 medical and health sciences, 0302 clinical medicine, Republic of Korea, Humans, Colectomy, Republic of Korea / epidemiology, Aged, Neoplasm Staging, Retrospective Studies, Colonic Neoplasms / diagnosis, Survival Rate, Colectomy / methods, Survival Rate / trends, Treatment Outcome, Mesocolon / surgery, Colonic Neoplasms, Female, Adenocarcinoma / surgery, Follow-Up Studies, Mesocolon
Description: BACKGROUND: Comparable to circumferential resection margin in rectal cancer, radial margin is a potential prognostic factor in colon cancer that has just begun to be studied. No previous studies have investigated the influence of radial margin in the context of complete mesocolic excision. OBJECTIVE: This study aimed to examine the impact of radial margin on oncologic outcomes after complete mesocolic excision for colon cancer. DESIGN: We retrospectively reviewed patients with stage I to III colon cancer who underwent curative resection from October 2010 to March 2013. SETTINGS: This study was conducted using the prospective colorectal cancer registry of Severance hospital. PATIENTS: A total of 834 consecutive patients who underwent complete mesocolic excision for colon adenocarcinoma were included. INTERVENTIONS: We assigned patients into 3 groups according to radial margin distance: group A, radial margin ≥2.0 mm; group B, 1.0 ≤ radial margin < 2.0 mm; group C, radial margin MAIN OUTCOMES AND MEASURES: Overall survival and disease-free survival were estimated. RESULTS: On adjusted Cox regression analysis, only group C was predictive of reduced overall survival (HR, 1.90; 95% CI, 1.11–3.25; p = 0.018) and disease-free survival (HR, 1.93; 95% CI, 1.28–2.89; p = 0.001). We thereby defined radial margin threatening as radial margin p = 0.743) and FOLFOX (HR, 1.23; 95% CI, 0.57–2.64; p = 0.581) chemotherapy did not affect disease-free survival in patients with radial margin threatening. LIMITATIONS: This study has the limitations inherent in all retrospective, single-institution studies. CONCLUSIONS: Even with complete mesocolic excision, radial margin Video Abstract at http://links.lww.com/DCR/B125. IMPORTANCIA DEL MARGEN RADIAL EN PACIENTES SOMETIDOS A ESCISIÓN MESOCÓLICA COMPLETA PARA CÁNCER DEL COLON ANTECEDENTES: Comparable al margen de resección circunferencial en cáncer rectal, el margen radial en cáncer de colon, es un factor pronóstico potencial, que recientemente comienza a estudiarse. Ningún estudio previo ha investigado la influencia del margen radial, en el contexto de la escisión mesocólica completa. OBJETIVO: Examinar en cáncer de colon, el impacto del margen radial en los resultados oncológicos, después de la escisión mesocólica completa. DISEÑO: Revisión retrospectiva de pacientes con cáncer de colon en estadio I-III, sometidos a resección curativa de octubre 2010 a marzo 2013. AJUSTES: Este estudio se realizó utilizando un registro prospectivo de cáncer colorrectal del hospital Severance. PACIENTES: Se incluyeron un total de 834 pacientes consecutivos con adenocarcinoma de colon, sometidos a escisión mesocólica completa. Dividimos a los pacientes en 3 grupos según la distancia del margen radial: grupo A, margen radial ≥ 2.0 mm; grupo B, 1.0 ≤ margen radial PRINCIPALES MEDIDAS DE RESULTADOS: Se estimó la supervivencia general y la supervivencia libre de enfermedad. RESULTADOS: En el análisis de regresión de Cox ajustado, solo el grupo C fue predictivo de supervivencia global reducida (HR, 1.90; IC 95%, 1.11–3.25; p = 0.018) y supervivencia libre de enfermedad (HR, 1.93; IC 95%, 1.28–2.89; p = 0.001). Definimos como margen radial amenazante, un margen radial p = 0.743) y FOLFOX (HR, 1,23; IC 95%, 0,57–2,64; p = 0,581), no afectó la supervivencia libre de enfermedad en pacientes con riesgo de margen radial. LIMITACIONES: Este estudio tiene limitaciones inherentes a todos los estudios retrospectivos de una sola institución. CONCLUSIONES: Aun con la escisión mesocólica completa, el margen radial Video Resumen en http://links.lww.com/DCR/B125.
Document Type: Article
Language: English
ISSN: 0012-3706
DOI: 10.1097/dcr.0000000000001569
Access URL: https://pubmed.ncbi.nlm.nih.gov/31977585
https://journals.lww.com/10.1097/DCR.0000000000001569
https://pubmed.ncbi.nlm.nih.gov/31977585/
https://www.ncbi.nlm.nih.gov/pubmed/31977585
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179964
https://yonsei.pure.elsevier.com/en/publications/significance-of-radial-margin-in-patients-undergoing-complete-mes
Rights: CC BY NC ND
Accession Number: edsair.doi.dedup.....b475dd6c0896b99576be6de879809dbd
Database: OpenAIRE
Description
Abstract:BACKGROUND: Comparable to circumferential resection margin in rectal cancer, radial margin is a potential prognostic factor in colon cancer that has just begun to be studied. No previous studies have investigated the influence of radial margin in the context of complete mesocolic excision. OBJECTIVE: This study aimed to examine the impact of radial margin on oncologic outcomes after complete mesocolic excision for colon cancer. DESIGN: We retrospectively reviewed patients with stage I to III colon cancer who underwent curative resection from October 2010 to March 2013. SETTINGS: This study was conducted using the prospective colorectal cancer registry of Severance hospital. PATIENTS: A total of 834 consecutive patients who underwent complete mesocolic excision for colon adenocarcinoma were included. INTERVENTIONS: We assigned patients into 3 groups according to radial margin distance: group A, radial margin ≥2.0 mm; group B, 1.0 ≤ radial margin < 2.0 mm; group C, radial margin MAIN OUTCOMES AND MEASURES: Overall survival and disease-free survival were estimated. RESULTS: On adjusted Cox regression analysis, only group C was predictive of reduced overall survival (HR, 1.90; 95% CI, 1.11–3.25; p = 0.018) and disease-free survival (HR, 1.93; 95% CI, 1.28–2.89; p = 0.001). We thereby defined radial margin threatening as radial margin p = 0.743) and FOLFOX (HR, 1.23; 95% CI, 0.57–2.64; p = 0.581) chemotherapy did not affect disease-free survival in patients with radial margin threatening. LIMITATIONS: This study has the limitations inherent in all retrospective, single-institution studies. CONCLUSIONS: Even with complete mesocolic excision, radial margin Video Abstract at http://links.lww.com/DCR/B125. IMPORTANCIA DEL MARGEN RADIAL EN PACIENTES SOMETIDOS A ESCISIÓN MESOCÓLICA COMPLETA PARA CÁNCER DEL COLON ANTECEDENTES: Comparable al margen de resección circunferencial en cáncer rectal, el margen radial en cáncer de colon, es un factor pronóstico potencial, que recientemente comienza a estudiarse. Ningún estudio previo ha investigado la influencia del margen radial, en el contexto de la escisión mesocólica completa. OBJETIVO: Examinar en cáncer de colon, el impacto del margen radial en los resultados oncológicos, después de la escisión mesocólica completa. DISEÑO: Revisión retrospectiva de pacientes con cáncer de colon en estadio I-III, sometidos a resección curativa de octubre 2010 a marzo 2013. AJUSTES: Este estudio se realizó utilizando un registro prospectivo de cáncer colorrectal del hospital Severance. PACIENTES: Se incluyeron un total de 834 pacientes consecutivos con adenocarcinoma de colon, sometidos a escisión mesocólica completa. Dividimos a los pacientes en 3 grupos según la distancia del margen radial: grupo A, margen radial ≥ 2.0 mm; grupo B, 1.0 ≤ margen radial PRINCIPALES MEDIDAS DE RESULTADOS: Se estimó la supervivencia general y la supervivencia libre de enfermedad. RESULTADOS: En el análisis de regresión de Cox ajustado, solo el grupo C fue predictivo de supervivencia global reducida (HR, 1.90; IC 95%, 1.11–3.25; p = 0.018) y supervivencia libre de enfermedad (HR, 1.93; IC 95%, 1.28–2.89; p = 0.001). Definimos como margen radial amenazante, un margen radial p = 0.743) y FOLFOX (HR, 1,23; IC 95%, 0,57–2,64; p = 0,581), no afectó la supervivencia libre de enfermedad en pacientes con riesgo de margen radial. LIMITACIONES: Este estudio tiene limitaciones inherentes a todos los estudios retrospectivos de una sola institución. CONCLUSIONES: Aun con la escisión mesocólica completa, el margen radial Video Resumen en http://links.lww.com/DCR/B125.
ISSN:00123706
DOI:10.1097/dcr.0000000000001569