Pelvic Diameter is not Associated with Positive Circumferential Resection Margin in Rectal Cancer: Retrospective Analysis of 78 Cases

 

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Abstract

Objective To identify if there is an association between pelvic entry and pelvic outlet diameters with increased positive circumferential resection margin (CRM) in rectal cancer.

Introduction Positive CRM in rectal cancer is a major predictor for local and distant recurrence. Pelvic diameters may be related to the difficulty of dissection, as well as intrinsic tumor characteristics such as tumor size, location, distance from the anal margin, and T stage, which may compromise the integrity of the mesorectum and circumferential margin involvement.

Methods A retrospective review of the patient's medical records who underwent surgical resection of rectal adenocarcinoma from January 2012 to June 2022 was performed. The patient's preoperative staging, operative characteristics, and histopathologic outcomes were gathered from the medical records. Preoperative MRI scanning was done in all patients. MRI pelvimetry was done by two observers. CRM involvement was recorded as stated in the pathology report. Pelvimetry variables were dichotomized according to their mean values for correlation analysis. The odds ratio (OR) was calculated from a binary logistics regression model to assess the relation between the positive CRM and the independent variables.

Results A total of 78 patients were included in this study. A positive CRM was reported in 10 patients (12.8%). BMI >27.4 + 6.6 (p = 0.02), positive extramural vascular invasion (p = 0.027), positive CRM by MRI scanning (p = 0.004), and anal sphincter involvement (p = 0.03) were associated with positive CRM. Pelvimetry values were not associated with a positive CRM.

Conclusion No association was found between the pelvic diameters measured by MRI pelvimetry with a positive CRM.

Statement

What does this paper add to the literature?

This manuscript shows that no significant association between narrow margins in MRI pelvimetry and CRM involvement was found. Concluding that MRI pelvimetry dimensions are not associated with CRM involvement in rectal cancer surgery.

Ethics Approval

This study was approved by the hospital ethics committee. (CONBIOETICA-09-CEI-011–20160627)

This paper has not been presented in any meeting presentation. This paper is not currently under review by another journal. This paper has not been accepted for publication elsewhere.

Publication History

Received: 11 September 2023

Accepted: 07 February 2024

Article published online:
11 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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