title: Adequate Margins to Prevent Local Re-recurrence of Rectal Cancer: Viewpoint of Pathological Findings.
abstract: BACKGROUND
  A sufficient surgical margin is critical for preventing re-recurrence and achieving R0 status after resection of a local recurrence of rectal cancer (LRRC).
  
  
  METHODS
  Re-recurrence-free survival was analyzed in 110 cases of LRRC according to histological type of primary lesion. The circumferential resection margin (CRM) was classified as 'R1' (x=0 μm), 'R0 shortness' (0 μm <x<2,000 μm), or 'R0 longness' (x≥2,000 μm). The histological change from the primary lesion to the recurrent lesion was classified as 'No change pattern', from well- to moderately-differentiated (W/M) to an expanding lesion; as 'Change pattern', from W/M to an infiltrating lesion.
  
  
  RESULTS
  Re-recurrence-free survival was better in 'R0 longness' than 'R0 shortness' groups and showed that 'No change pattern' cases had considerably better prognosis than 'Change pattern' cases.
  
  
  CONCLUSIONS
  Ensuring a CRM >2,000 μm during resection of LRRC is more likely to prevent re-recurrence. Cases with poorly differentiated carcinoma from the primary lesion to the recurrent lesion tend to have poor prognoses.
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan kkomori@aichi-cc.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Komori
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Uemura
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Natsume
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Kawakami
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Iwata
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tsutsuyama
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Shigeyoshi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akazawa
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000517:prevention & control*; D012189:Retrospective Studies
keywords: Local recurrence of rectal cancer; circumferential resection margin