Factors influencing pathologic results after total mesorectal excision for rectal cancer: Analysis of consecutive 100 cases

Seung Hyuk Baik, Nam Kyu Kim, Kang Young Lee, Seung Kook Sohn, Chang Hwan Cho, Myeong Jin Kim, Hogeun Kim, Rina K. Shinn

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Abstract

Background: The aim of this study was to analyze clinical and anatomical factors affecting the pathologic quality of the resected specimen after total mesorectal excision (TME) for rectal cancer. Methods: A total of 100 patients who underwent TME for mid or low rectal cancer were evaluated prospectively. MRI pelvimetry data (transverse diameter, obstetric conjugate, interspinous distance, sacrum length, and sacrum depth) were analyzed as anatomically affecting factors to postoperative specimen quality. Sex, body mass index (BMI), type of surgery, tumor size, and tumor distance from the anal verge were analyzed as clinically affecting factors. The gross judgment of resected specimen, circumferential resection margin and the number of harvested lymph nodes were used to access postoperative specimen quality. Results: The univariate and multivariate analysis showed that narrow obstetric conjugate and shorter interspinous distance were related to the inadequate quality of the mesorectum in the specimen (P = 0.022, P = 0.030). Interspinous distance was a predicting factor of a positive circumferential resection margin (P = 0.007). There were no clinical factors affecting the inadequate quality of the mesorectum or positive circumferential resection margin. Moreover, there were no clinico-anatomical factors affecting the number of harvested lymph nodes after TME. Conclusion: Narrow obstetric conjugate and shorter interspinous distance were factors leading to poor postoperative specimen quality. Rectal cancer patients with narrow obstetric conjugate or shorter interspinous distance should be considered as high-risk patients with regard to specimen quality, which is in turn related to oncological outcome.

Original languageEnglish
Pages (from-to)721-728
Number of pages8
JournalAnnals of surgical oncology
Volume15
Issue number3
DOIs
Publication statusPublished - 2008 Mar 1

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Rectal Neoplasms
Obstetrics
Sacrum
Pelvimetry
Lymph Nodes
Neoplasms
Body Mass Index
Multivariate Analysis
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Hyuk Baik, Seung ; Kyu Kim, Nam ; Young Lee, Kang ; Kook Sohn, Seung ; Hwan Cho, Chang ; Jin Kim, Myeong ; Kim, Hogeun ; Shinn, Rina K. / Factors influencing pathologic results after total mesorectal excision for rectal cancer : Analysis of consecutive 100 cases. In: Annals of surgical oncology. 2008 ; Vol. 15, No. 3. pp. 721-728.
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abstract = "Background: The aim of this study was to analyze clinical and anatomical factors affecting the pathologic quality of the resected specimen after total mesorectal excision (TME) for rectal cancer. Methods: A total of 100 patients who underwent TME for mid or low rectal cancer were evaluated prospectively. MRI pelvimetry data (transverse diameter, obstetric conjugate, interspinous distance, sacrum length, and sacrum depth) were analyzed as anatomically affecting factors to postoperative specimen quality. Sex, body mass index (BMI), type of surgery, tumor size, and tumor distance from the anal verge were analyzed as clinically affecting factors. The gross judgment of resected specimen, circumferential resection margin and the number of harvested lymph nodes were used to access postoperative specimen quality. Results: The univariate and multivariate analysis showed that narrow obstetric conjugate and shorter interspinous distance were related to the inadequate quality of the mesorectum in the specimen (P = 0.022, P = 0.030). Interspinous distance was a predicting factor of a positive circumferential resection margin (P = 0.007). There were no clinical factors affecting the inadequate quality of the mesorectum or positive circumferential resection margin. Moreover, there were no clinico-anatomical factors affecting the number of harvested lymph nodes after TME. Conclusion: Narrow obstetric conjugate and shorter interspinous distance were factors leading to poor postoperative specimen quality. Rectal cancer patients with narrow obstetric conjugate or shorter interspinous distance should be considered as high-risk patients with regard to specimen quality, which is in turn related to oncological outcome.",
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Factors influencing pathologic results after total mesorectal excision for rectal cancer : Analysis of consecutive 100 cases. / Hyuk Baik, Seung; Kyu Kim, Nam; Young Lee, Kang; Kook Sohn, Seung; Hwan Cho, Chang; Jin Kim, Myeong; Kim, Hogeun; Shinn, Rina K.

In: Annals of surgical oncology, Vol. 15, No. 3, 01.03.2008, p. 721-728.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors influencing pathologic results after total mesorectal excision for rectal cancer

T2 - Analysis of consecutive 100 cases

AU - Hyuk Baik, Seung

AU - Kyu Kim, Nam

AU - Young Lee, Kang

AU - Kook Sohn, Seung

AU - Hwan Cho, Chang

AU - Jin Kim, Myeong

AU - Kim, Hogeun

AU - Shinn, Rina K.

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Y1 - 2008/3/1

N2 - Background: The aim of this study was to analyze clinical and anatomical factors affecting the pathologic quality of the resected specimen after total mesorectal excision (TME) for rectal cancer. Methods: A total of 100 patients who underwent TME for mid or low rectal cancer were evaluated prospectively. MRI pelvimetry data (transverse diameter, obstetric conjugate, interspinous distance, sacrum length, and sacrum depth) were analyzed as anatomically affecting factors to postoperative specimen quality. Sex, body mass index (BMI), type of surgery, tumor size, and tumor distance from the anal verge were analyzed as clinically affecting factors. The gross judgment of resected specimen, circumferential resection margin and the number of harvested lymph nodes were used to access postoperative specimen quality. Results: The univariate and multivariate analysis showed that narrow obstetric conjugate and shorter interspinous distance were related to the inadequate quality of the mesorectum in the specimen (P = 0.022, P = 0.030). Interspinous distance was a predicting factor of a positive circumferential resection margin (P = 0.007). There were no clinical factors affecting the inadequate quality of the mesorectum or positive circumferential resection margin. Moreover, there were no clinico-anatomical factors affecting the number of harvested lymph nodes after TME. Conclusion: Narrow obstetric conjugate and shorter interspinous distance were factors leading to poor postoperative specimen quality. Rectal cancer patients with narrow obstetric conjugate or shorter interspinous distance should be considered as high-risk patients with regard to specimen quality, which is in turn related to oncological outcome.

AB - Background: The aim of this study was to analyze clinical and anatomical factors affecting the pathologic quality of the resected specimen after total mesorectal excision (TME) for rectal cancer. Methods: A total of 100 patients who underwent TME for mid or low rectal cancer were evaluated prospectively. MRI pelvimetry data (transverse diameter, obstetric conjugate, interspinous distance, sacrum length, and sacrum depth) were analyzed as anatomically affecting factors to postoperative specimen quality. Sex, body mass index (BMI), type of surgery, tumor size, and tumor distance from the anal verge were analyzed as clinically affecting factors. The gross judgment of resected specimen, circumferential resection margin and the number of harvested lymph nodes were used to access postoperative specimen quality. Results: The univariate and multivariate analysis showed that narrow obstetric conjugate and shorter interspinous distance were related to the inadequate quality of the mesorectum in the specimen (P = 0.022, P = 0.030). Interspinous distance was a predicting factor of a positive circumferential resection margin (P = 0.007). There were no clinical factors affecting the inadequate quality of the mesorectum or positive circumferential resection margin. Moreover, there were no clinico-anatomical factors affecting the number of harvested lymph nodes after TME. Conclusion: Narrow obstetric conjugate and shorter interspinous distance were factors leading to poor postoperative specimen quality. Rectal cancer patients with narrow obstetric conjugate or shorter interspinous distance should be considered as high-risk patients with regard to specimen quality, which is in turn related to oncological outcome.

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