title: [An appropriate distal resection margin for lower rectal cancer after preoperative chemoradiotherapy].
abstract: In recent years, with the increase in the adoption of anus-preserving surgery, understanding of residual lower rectal cancer distribution to the anal side after chemoradiotherapy (CRT) has become an increasingly important issue. We aimed to clarify the pathological safe distal resection margin for lower rectal cancer after preoperative CRT. This study included 36 patients with lower third rectal cancer, who underwent preoperative CRT. We classified the gross tumor appearance as type 0-II like, Borrmann type 2, and Borrmann type 5. Whole-mount sections were used for pathological examination. We examined all slides and measured the extent of residual cancer spread. In many cases, residual cancer was observed in the deeper layers of the lesion, and in none of the cases was the cancer limited to the superficial layer. With regard to lateral distribution, tumors with a type 0-II like appearance showed a wider extent of lateral cancer spread from the optimal margin. In conclusion, although CRT contributes to tumor reduction, attention should be paid to both circumferential and lateral residual cancer spread. Our results suggest that the lateral distribution of residual cancer spread could be predicted by gross tumor appearance. This is an ongoing study.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Satoru
authors.initials: S
authors.lastname: Yasukawa
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Naoko
authors.initials: N
authors.lastname: Masuzawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kishimoto
authors.forename: Eiichi
authors.initials: E
authors.lastname: Konishi
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D059248:Chemoradiotherapy / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D002166:Camptothecin