[Spread of rectal cancer in the distal mesorectum: a report of 46 cases].
OBJECTIVE
Total mesorectum excision (TME) for rectal cancer may reduce local recurrence by complete eradication of metastatic foci in the distal mesorectum. While the spread regulation of rectal cancer in the distal mesorectum and ideal length of mesorectum resection are still unclear. This study was to investigate the spread of rectal cancer in the distal mesorectum.


METHODS
The whole-mount section with HE staining was used to detect tumor spread in the mesorectum of 46 rectal cancer patients. The correlation of tumor spread to clinicopathologic parameters was analyzed by Logistic regression.


RESULTS
The occurrence rate of distal mural invasion of rectal cancer was 10.9% with the maximal distance of 1.5 cmû that of distal mesorectum spread was 21.7% with the maximal distance of 4.0 cm, which included metastasis in lymph nodes, solitary tumor foci, vessel and perineural invasion. Multivariate analysis showed that TNM stage was the only significant factor influencing distal spread of rectal cancer.


CONCLUSIONS
Spread of rectal cancer in the distal mesorectum is common. Resecting at least 5 cm of the mesorectum distal to rectal cancer is recommended.
Zhang
Wei-Jian
WJ
Department of Gastrointestinal Surgery, The First Peopleo's Hospital of Guangzhou, Guangzhou, Guangdong, 510160, P R China. gzhoucdctsh@126.com
Chen
Jin-Pei
JP
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012007:Rectum / Q000473:pathology* / Q000601:surgery