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

Vergara-Fernández, Omar / Ruiz-Muñoz, Erick Alejandro / la Peña, Danilo Tueme-de / Bravo-Ávila, Héctor E. / Hoyos-Torres, Alejandro / Salgado-Nesme, Noel

Journal of Coloproctology

2024  Volume 44, Issue 01, Page(s) e63–e70

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 ... ...

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.
Keywords magnetic resonance pelvimetry ; pelvic outlet diameter ; pelvimetry ; circumferential resection margin ; rectal cancer
Language English
Publishing date 2024-03-01
Publisher Thieme Revinter Publicações Ltda.
Publishing place Stuttgart ; New York
Document type Article
ZDB-ID 2664477-0
ISSN 2317-6423 ; 2237-9363 ; 2317-6423
ISSN (online) 2317-6423
ISSN 2237-9363 ; 2317-6423
DOI 10.1055/s-0044-1782152
Database Thieme publisher's database

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