Cancer Research and Treatment

Original Articles

Redefining the Positive Circumferential Resection Margin by Incorporating Preoperative Chemoradiotherapy Treatment Response in Locally Advanced Rectal Cancer: A Multicenter Validation Study: Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Chang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim; Cancer Res Treat. 2018;50(2):506-517. Published online May 24, 2017; DOI: https://doi.org/10.4143/crt.2016.607

Purpose
This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods
Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results
After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion
Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.

Citations

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Tailored Strategy for Locally Advanced Rectal Carcinoma (GRECCAR 4): Long-term Results From a Multicenter, Randomized, Open-Label, Phase II Trial
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stephanie Nougaret
Diseases of the Colon & Rectum.2022; 65(8): 986. CrossRef
Colorectal Cancer Surgery Quality in Manitoba: A Population-Based Descriptive Analysis
Iresha Ratnayake, Jason Park, Natalie Biswanger, Allison Feely, Grace Musto, Kathleen Decker
Current Oncology.2021; 28(3): 2239. CrossRef

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No Association of Positive Superficial and/or Deep Margins with Local Recurrence in Invasive Breast Cancer Treated with Breast-Conserving Surgery: Tae In Yoon, Jong Won Lee, Sae Byul Lee, Guiyun Sohn, Jisun Kim, Il Young Chung, Hee Jeong Kim, Beom Seok Ko, Byung Ho Son, Gyungyub Gong, Sung-Bae Kim, Su Ssan Kim, Seung Do Ahn, Minsung Chung, Sei Hyun Ahn; Cancer Res Treat. 2018;50(1):275-282. Published online April 14, 2017; DOI: https://doi.org/10.4143/crt.2017.041

Abstract PDF Supplementary Material PubReader ePub

Purpose
We evaluated the effect of positive superficial and/or deep margin status on local recurrence (LR) in invasive breast cancer treated with breast-conserving surgery (BCS) followed by radiotherapy.
Materials and Methods
In total, 3,403 stage 1 and 2 invasive breast cancer patients treated with BCS followed by radiotherapy from January 2000 to December 2008 were included in this study. These patients were divided into three groups according to margin status: clear resection margin status for all sections (group 1, n=3,195); positive margin status in superficial and/or deep sections (group 2, n=121); and positive peripheral parenchymal margin regardless of superficial and/or deep margin involvement (group 3, n=87). The LR-free survival between these three groups was compared and the prognostic role of margin status was analyzed.
Results
Across all groups, age, tumor size, nodal status, and human epidermal growth factor receptor 2 status did not significantly differ. High grade, positive extensive intraductal component, hormone receptor positivity, hormone therapy received, and chemotherapy not received were more prevalent in groups 2 and 3 than in group 1. Five-year LR rates in groups 1, 2, and 3 were 1.9%, 1.7%, and 7.7%, respectively. Multivariate analysis revealed that group 3 was a significant predictor for LR (hazard ratio [HR], 4.78; p < 0.001), but that positive superficial and/or deep margin was not (HR, 0.66; p=0.57).
Conclusion
Superficial and/or deep margin involvement following BCS is not an important predictor for LR.

Citations

Citations to this article as recorded by

Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy
Suma Susan Meloot, Ciniraj Raveendran, IP Yadev
Indian Journal of Surgical Oncology.2025;[Epub] CrossRef
Assessment of Eligibility and Utilization of Accelerated Partial Breast Irradiation in Korean Breast Cancer Patients (KROG 22-15)
Seok-Joo Chun, Ji Hwan Jo, Yong Bae Kim, Sangjoon Park, Sung-Ja Ahn, Su Ssan Kim, Kyubo Kim, Kyung Hwan Shin
Cancer Research and Treatment.2024; 56(2): 549. CrossRef
Surgical margin status and survival outcomes of breast cancer patients treated with breast-conserving surgery and whole-breast irradiation after neoadjuvant chemotherapy
Jong-Ho Cheun, Young Joo Lee, Jun-Hee Lee, Yungil Shin, Jung Whan Chun, Soo Yeon Baek, Hong-Kyu Kim, Han-Byoel Lee, Jonghan Yu, Byung Joo Chae, Wonshik Han, Jeong Eon Lee
Breast Cancer Research and Treatment.2022; 194(3): 683. CrossRef
Comparison of Recurrence Rate Between Re-Excision With Radiotherapy and Radiotherapy-Only Groups in Surgical Margin Involvement of In Situ Carcinoma
Jun-Hee Lee, Hyunjun Lee, Yoon Ju Bang, Jai Min Ryu, Se Kyung Lee, Jonghan Yu, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Byung Joo Chae
Journal of Breast Cancer.2022; 25(4): 288. CrossRef
Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery
Serena Bertozzi, Ambrogio P Londero, Jose Andres Diaz Nanez, Francesco Leone, Barbara Baita, Lucia La Verghetta, Milena Nobile, Daria Almesberger, Carla Cedolini
Clinical and Experimental Obstetrics & Gynecology.2022;[Epub] CrossRef
Feasibility and safety of breast-conserving surgery via a periareolar incision for cancers located far from the nipple–areolar complex: a retrospective study
Joohyun Woo, Jihae Lee, Se Hyun Paek, Woosung Lim
Journal of Cancer Research and Clinical Oncology.2021; 147(3): 893. CrossRef
Breast-conserving surgery with 3D-printed surgical guide: a single-center, prospective clinical study
Zhen-Yu Wu, Hee Jeong Kim, Jongwon Lee, Il Yong Chung, Jisun Kim, Saebyeol Lee, Byung Ho Son, Sei-Hyun Ahn, Hak Hee Kim, Joon Beom Seo, Jae Ho Jeong, Gyungyub Gong, Namkug Kim, BeomSeok Ko
Scientific Reports.2021;[Epub] CrossRef
Usefulness of 3D-surgical guides in breast conserving surgery after neoadjuvant treatment
Han Shin Lee, Hee Jeong Kim, Il Yong Chung, Jisun Kim, Sae Byul Lee, Jong Won Lee, Byung Ho Son, Sei Hyun Ahn, Hak Hee Kim, Joon Beom Seo, Jin Hee Ahn, Gyungyub Gong, Sangwook Lee, Namkug Kim, Beom Seok Ko
Scientific Reports.2021;[Epub] CrossRef
Partial chest wall radiation therapy for positive or close surgical margins after modified radical mastectomy for breast cancer without lymph node metastasis
Naoya Ishibashi, Haruna Nishimaki, Toshiya Maebayashi, Keita Adachi, Kenichi Sakurai, Shinobu Masuda, Masaharu Hata, Masahiro Okada
Asia-Pacific Journal of Clinical Oncology.2020; 16(1): 28. CrossRef
Impact of Oncotype DX Recurrence Score on the Patterns of Locoregional Recurrence in Breast Cancer (Korean Radiation Oncology Group 19-06)
Kyubo Kim, Jinhong Jung, Kyung Hwan Shin, Jin Ho Kim, Ji Hyun Chang, Su Ssan Kim, Haeyoung Kim, Won Park, Yong Bae Kim, Jee Suk Chang
Journal of Breast Cancer.2020; 23(3): 314. CrossRef
Magnetic resonance imaging based 3-dimensional printed breast surgical guide for breast-conserving surgery in ductal carcinoma in situ: a clinical trial
Zhen-Yu Wu, Aisha Alzuhair, Heejeong Kim, Jong Won Lee, Il Yong Chung, Jisun Kim, Sae Byul Lee, Byung Ho Son, Gyungyub Gong, Hak Hee Kim, Joon Beom Seo, Sei Hyun Ahn, Namkug Kim, BeomSeok Ko
Scientific Reports.2020;[Epub] CrossRef
Aktuelle chirurgische Therapie des Mammakarzinoms
Jasmin Zeindler, Fabienne Schwab
InFo Hämatologie + Onkologie.2019; 22(4): 15. CrossRef
Comparing long-term local recurrence rates of surgical and non-surgical management of close anterior margins in breast conserving surgery
George Boundouki, Joseph Ryan Wong Sik Hee, Natalie Croghan, Katie Stocking, Andrew Pieri, Adam Critchley, Cliona C. Kirwan, James R. Harvey
Breast Cancer Research and Treatment.2019; 176(2): 311. CrossRef
Therapy of isolated locoregional recurrent carcinoma of the breast
Lena Gabriel, Marina Schmidt, Stephanie Juhasz-Böss, Patrick Melchior, Anika von Heesen, Gilda Schmidt, Nicole Kranzhöfer, Erich-Franz Solomayer, Ingolf Juhasz-Böss, Georg-Peter Breitbach
Archives of Gynecology and Obstetrics.2019; 300(2): 365. CrossRef

12,397 View
430 Download
13 Web of Science
14 Crossref

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