title: [Mesorectal metastasis of middle and lower rectal cancer].
abstract: OBJECTIVE
  To detect mesorectal metastasis of middle and lower rectal cancer and to evaluate its relationship with clinicopathologic characteristics.
  
  
  METHODS
  Cancer specimens resected from 56 patients with middle and lower rectal cancer who received total mesorectal excision were examined by routine pathologic observation. The relationship between mesorectal metastasis and clinicopathologic characteristics of middle and lower rectal cancer was also investigated.
  
  
  RESULTS
  Mesorectal metastasis was detected in 36 (64.3%) of 56 cancer specimens. In 18 cancer specimens with tumor diameter > or = 5 cm, 15 (83.3%) were detected mesorectal metastasis, while in 38 cancer specimens with tumor diameter < 5 cm only 21 (55.3%) were detected mesorectal metastasis (P = 0.041). Mesorectal metastasis was more frequent in T(3) cancer specimens (81.5%) and T(2) cancer specimens (56.6%), compared with T(1) cancer specimens (1/6) (P = 0.007). 85.7% poorly differentiated cancer specimens were detected mesorectal metastasis, while moderate and well-differentiated cancer specimens were only 63.2% and 1/5 respectively (P = 0.028). Mesorectal metastasis was more frequent in stage III cancer specimens (100%), compared with stage II and I cancer specimens (27.3% and 1/5 respectively, P = 0.000). No significant correlations were found between mesorectal metastasis and other variables such as age, gender and Ming classification (P > 0.05).
  
  
  CONCLUSIONS
  Mesorectal metastasis of middle and lower rectal cancer has significant correlation with tumor diameter, tumor invasion, tumor differentiation and TNM stage. Total mesorectal excision or > or = 5 cm mesorectal distal to the rectal tumor should be followed in the management of middle and lower rectal cancer.
authors.affiliation: Department of General Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, China. reiqi123@sohu.com
authors.forename: Jin
authors.initials: J
authors.lastname: Wan
authors.forename: Ze-yu
authors.initials: ZY
authors.lastname: Wu
authors.forename: Jia-lin
authors.initials: JL
authors.lastname: Du
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
authors.forename: Zhi-du
authors.initials: ZD
authors.lastname: Wang
authors.forename: Hua-huan
authors.initials: HH
authors.lastname: Lin
authors.forename: Xin-lan
authors.initials: XL
authors.lastname: Luo
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008643:Mesentery / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery