Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients

YoungWan Kim, Namkyu Kim, Byung Soh Min, Hyuk Huh, Jin Soo Kim, Jeong Yeon Kim, Seung Kook Sohn, Chang Hwan Cho

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: In patients undergoing total mesorectal excision (TME), the clinical variables most relevant to anastomotic recurrence have not been identified. We evaluated factors associated with anastomotic recurrence in patients undergoing TME and the impact of a reduced distal margin on anastomotic recurrence. Methods: Thirty-eight patients with anastomotic recurrence were compared with 876 patients who received curative rectal cancer surgery. Patients were compared according to: (1) the presence of anastomotic recurrence (recurrence vs. recurrence-free), (2) distal margin length (≤10 mm vs. >10 mm) and (3) additional treatment (none, adjuvant, or neoadjuvant). The risk factors for anastomotic recurrence were analyzed. Results: In the recurrence group, an advanced T stage (T3 and T4) (P = 0.01) microscopic distal margin involvement (P = 0.002) and an elevated CEA level (>5 ng/ml) (P = 0.04) were more commonly found. The incidence of anastomotic recurrence was not higher in the distal margin ≤10 mm group and did not differ according to additional treatment. The multivariate analysis showed that an advanced T stage (T3 and T4) and microscopic distal margin involvement were risk factors for anastomotic recurrence. Conclusion: A distal margin ≤10 mm appears to be acceptable in terms of anastomotic recurrence. Patients with a positive distal margin, on the postoperative pathology, should be considered at high risk for anastomotic recurrence.

Original languageEnglish
Pages (from-to)58-64
Number of pages7
JournalJournal of Surgical Oncology
Volume99
Issue number1
DOIs
Publication statusPublished - 2009 Jan 1

Fingerprint

Rectal Neoplasms
Recurrence
Multivariate Analysis
Pathology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, YoungWan ; Kim, Namkyu ; Min, Byung Soh ; Huh, Hyuk ; Kim, Jin Soo ; Kim, Jeong Yeon ; Sohn, Seung Kook ; Cho, Chang Hwan. / Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients. In: Journal of Surgical Oncology. 2009 ; Vol. 99, No. 1. pp. 58-64.
@article{9cd5a4c3bab24b479df402fd289838e7,
title = "Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients",
abstract = "Background: In patients undergoing total mesorectal excision (TME), the clinical variables most relevant to anastomotic recurrence have not been identified. We evaluated factors associated with anastomotic recurrence in patients undergoing TME and the impact of a reduced distal margin on anastomotic recurrence. Methods: Thirty-eight patients with anastomotic recurrence were compared with 876 patients who received curative rectal cancer surgery. Patients were compared according to: (1) the presence of anastomotic recurrence (recurrence vs. recurrence-free), (2) distal margin length (≤10 mm vs. >10 mm) and (3) additional treatment (none, adjuvant, or neoadjuvant). The risk factors for anastomotic recurrence were analyzed. Results: In the recurrence group, an advanced T stage (T3 and T4) (P = 0.01) microscopic distal margin involvement (P = 0.002) and an elevated CEA level (>5 ng/ml) (P = 0.04) were more commonly found. The incidence of anastomotic recurrence was not higher in the distal margin ≤10 mm group and did not differ according to additional treatment. The multivariate analysis showed that an advanced T stage (T3 and T4) and microscopic distal margin involvement were risk factors for anastomotic recurrence. Conclusion: A distal margin ≤10 mm appears to be acceptable in terms of anastomotic recurrence. Patients with a positive distal margin, on the postoperative pathology, should be considered at high risk for anastomotic recurrence.",
author = "YoungWan Kim and Namkyu Kim and Min, {Byung Soh} and Hyuk Huh and Kim, {Jin Soo} and Kim, {Jeong Yeon} and Sohn, {Seung Kook} and Cho, {Chang Hwan}",
year = "2009",
month = "1",
day = "1",
doi = "10.1002/jso.21166",
language = "English",
volume = "99",
pages = "58--64",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "1",

}

Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients. / Kim, YoungWan; Kim, Namkyu; Min, Byung Soh; Huh, Hyuk; Kim, Jin Soo; Kim, Jeong Yeon; Sohn, Seung Kook; Cho, Chang Hwan.

In: Journal of Surgical Oncology, Vol. 99, No. 1, 01.01.2009, p. 58-64.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients

AU - Kim, YoungWan

AU - Kim, Namkyu

AU - Min, Byung Soh

AU - Huh, Hyuk

AU - Kim, Jin Soo

AU - Kim, Jeong Yeon

AU - Sohn, Seung Kook

AU - Cho, Chang Hwan

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background: In patients undergoing total mesorectal excision (TME), the clinical variables most relevant to anastomotic recurrence have not been identified. We evaluated factors associated with anastomotic recurrence in patients undergoing TME and the impact of a reduced distal margin on anastomotic recurrence. Methods: Thirty-eight patients with anastomotic recurrence were compared with 876 patients who received curative rectal cancer surgery. Patients were compared according to: (1) the presence of anastomotic recurrence (recurrence vs. recurrence-free), (2) distal margin length (≤10 mm vs. >10 mm) and (3) additional treatment (none, adjuvant, or neoadjuvant). The risk factors for anastomotic recurrence were analyzed. Results: In the recurrence group, an advanced T stage (T3 and T4) (P = 0.01) microscopic distal margin involvement (P = 0.002) and an elevated CEA level (>5 ng/ml) (P = 0.04) were more commonly found. The incidence of anastomotic recurrence was not higher in the distal margin ≤10 mm group and did not differ according to additional treatment. The multivariate analysis showed that an advanced T stage (T3 and T4) and microscopic distal margin involvement were risk factors for anastomotic recurrence. Conclusion: A distal margin ≤10 mm appears to be acceptable in terms of anastomotic recurrence. Patients with a positive distal margin, on the postoperative pathology, should be considered at high risk for anastomotic recurrence.

AB - Background: In patients undergoing total mesorectal excision (TME), the clinical variables most relevant to anastomotic recurrence have not been identified. We evaluated factors associated with anastomotic recurrence in patients undergoing TME and the impact of a reduced distal margin on anastomotic recurrence. Methods: Thirty-eight patients with anastomotic recurrence were compared with 876 patients who received curative rectal cancer surgery. Patients were compared according to: (1) the presence of anastomotic recurrence (recurrence vs. recurrence-free), (2) distal margin length (≤10 mm vs. >10 mm) and (3) additional treatment (none, adjuvant, or neoadjuvant). The risk factors for anastomotic recurrence were analyzed. Results: In the recurrence group, an advanced T stage (T3 and T4) (P = 0.01) microscopic distal margin involvement (P = 0.002) and an elevated CEA level (>5 ng/ml) (P = 0.04) were more commonly found. The incidence of anastomotic recurrence was not higher in the distal margin ≤10 mm group and did not differ according to additional treatment. The multivariate analysis showed that an advanced T stage (T3 and T4) and microscopic distal margin involvement were risk factors for anastomotic recurrence. Conclusion: A distal margin ≤10 mm appears to be acceptable in terms of anastomotic recurrence. Patients with a positive distal margin, on the postoperative pathology, should be considered at high risk for anastomotic recurrence.

UR - http://www.scopus.com/inward/record.url?scp=58149397356&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149397356&partnerID=8YFLogxK

U2 - 10.1002/jso.21166

DO - 10.1002/jso.21166

M3 - Article

C2 - 18937260

AN - SCOPUS:58149397356

VL - 99

SP - 58

EP - 64

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 1

ER -