Adequate length of the surgical distal resection margin in rectal cancer: from the viewpoint of pathological findings.
BACKGROUND
Previous studies have not identified how to determine the optimal distal margin in rectal cancer based on histopathological diagnosis. We examined the surgical distal resection margin from a histopathological viewpoint.


METHODS
We enrolled 629 patients. The type of distal spread was evaluated, and the maximum length of distal spread was measured using a micrometer.


RESULTS
The frequencies of discontinuous spread type were 1.0%, 8.4%, 52.9%, and 81.5%, and the average lengths of distal spread were .5 ± 1.3 mm, 7 ± 1.8 mm, 2.7 ± 2.4 mm, and 10.0 ± 9.5 mm for well-differentiated adenocarcinomas, moderately differentiated adenocarcinomas, solid (por1)-type poorly differentiated adenocarcinomas, and nonsolid (por2)-type poorly differentiated adenocarcinomas, (moderately vs solid [por1] type: P = .004), respectively.


CONCLUSIONS
The surgical distal resection margin based on pathological diagnosis is longer somewhat than that based on macroscopic findings. Therefore, it is important to select surgical procedures with great care to ensure an adequate surgical distal resection margin.
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa Nagoya, Aichi, 464-8681 Japan. kkomori@aichi-cc.jp
Koji
K
Komori
Yukihide
Y
Kanemitsu
Seiji
S
Ishiguro
Yasuhiro
Y
Shimizu
Tsuyoshi
T
Sano
Seiji
S
Ito
Tetsuya
T
Abe
Yoshiki
Y
Senda
Kazunari
K
Misawa
Yuichi
Y
Ito
Norihisa
N
Uemura
Tomoyuki
T
Kato
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D018365:Neoplasm, Residual / Q000517:prevention & control*; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D019043:Vascular Neoplasms / Q000556:secondary; D014680:Veins / Q000473:pathology