TY - JOUR

T1 - Is the Longitudinal Margin of Carcinoma-Bearing Colon Resections a Neglected Parameter?

AU - Rørvig, Sara

AU - Schlesinger, Nis

AU - Mårtensson, Nina Løth

AU - Engel, Sara

AU - Engel, Ulla

AU - Holck, Susanne

N1 - CURIS 2014 NEXS 403

PY - 2014/3

Y1 - 2014/3

N2 - BACKGROUND: Resection of colon cancer with curative intent implies clear margins. An arbitrary requirement of 2 cm DtLM generally ensures surgical and pathological clearance. However, harvest of tumor-draining lymph nodes is related to DtLM. For this reason, an extended longitudinal margin becomes an issue. The major objective of the present study concerns quality development of colon resections, recording the status of DtLM, pT and pN stage, and the pathologists' reporting pattern.MATERIALS AND METHODS: The study comprised colectomy specimens obtained in 2010 to 2011 at Hvidovre Hospital with documented and suspected carcinoma. Specimens were stratified into 2 groups: DtLM < 5 cm and ≥ 5 cm. Data were correlated with lesional site, surgical approach, pT and pN stage and the pathologists' reporting approach.RESULTS: DtLM reporting was lacking in 6% of the specimens. DtLM was < 5 cm in 32% of the specimens. Sixty-three and 83.5% of the cancer specimens with DtLM < 5 cm were node-negative and stage pT3/4, respectively, compared with 49% and 87.5% of the ≥ 5 cm counterpart. The difference in percentage distribution of pN stage in the 2 groups was significant, and no significant difference was observed in relation to pT stage.CONCLUSION: This study suggests that DtLM < 5 cm in colon cancer surgery might result in diagnostic "understaging" and hence leaving metastasis in the patient.

AB - BACKGROUND: Resection of colon cancer with curative intent implies clear margins. An arbitrary requirement of 2 cm DtLM generally ensures surgical and pathological clearance. However, harvest of tumor-draining lymph nodes is related to DtLM. For this reason, an extended longitudinal margin becomes an issue. The major objective of the present study concerns quality development of colon resections, recording the status of DtLM, pT and pN stage, and the pathologists' reporting pattern.MATERIALS AND METHODS: The study comprised colectomy specimens obtained in 2010 to 2011 at Hvidovre Hospital with documented and suspected carcinoma. Specimens were stratified into 2 groups: DtLM < 5 cm and ≥ 5 cm. Data were correlated with lesional site, surgical approach, pT and pN stage and the pathologists' reporting approach.RESULTS: DtLM reporting was lacking in 6% of the specimens. DtLM was < 5 cm in 32% of the specimens. Sixty-three and 83.5% of the cancer specimens with DtLM < 5 cm were node-negative and stage pT3/4, respectively, compared with 49% and 87.5% of the ≥ 5 cm counterpart. The difference in percentage distribution of pN stage in the 2 groups was significant, and no significant difference was observed in relation to pT stage.CONCLUSION: This study suggests that DtLM < 5 cm in colon cancer surgery might result in diagnostic "understaging" and hence leaving metastasis in the patient.

KW - Carcinoma

KW - Colectomy

KW - Colonic Neoplasms

KW - Humans

KW - Neoplasm Staging

U2 - 10.1016/j.clcc.2013.11.007

DO - 10.1016/j.clcc.2013.11.007

M3 - Journal article

C2 - 24503112

VL - 13

SP - 68

EP - 72

JO - Clinical Colorectal Cancer

JF - Clinical Colorectal Cancer

SN - 1533-0028

IS - 1

ER -