Comparison of circumferential resection margin clearance criteria with survival after surgery for cancer of esophagus

Journal of Surgical Oncology, 05/03/2012

This study appears to lend credence to the RCP criteria for definition of circumferential resection margin (CRM) over the college of American Pathologists (CAP) criteria.

Methods

  • Patients (115) who underwent esophagectomy between 2000 and 2006 were included in this retrospective study.
  • Factors such as neo–adjuvant therapy, site, histological type, size, and lymph node involvement were tested to determine predictability of CRM involvement.
  • Along with these, age, sex, CRM, and adjuvant therapy were analyzed to determine influence on survival.

Results

  • On the basis of CRM, patients were divided into three groups (involved, 0.1–1 mm and >1mm).
  • Size (T) was the only factor strongly predictive of CRM involvement (P<0.001).
  • Size (T; P=0.04) and lymph node involvement (N; P=0.0003) were found to significantly influence overall survival (OS).
  • When patients with CRM (involved and 0.1–1mm) were compared with those with CRM>1 mm, OS was significantly prolonged in the latter (P=0.02).

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