Background. Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after
surgical resection of colorectal cancer (CRC) are associated with higher rates of recurrence and development of distant metastasis.
)is can influence the overall patient’s prognosis. )eaim of the current study was to identify pathological factors as predictors for
the involvement of resection margins in early T3 CRC. Patients and Methods. Fifty patients radiologically diagnosed to have cT3a/
b (CRC) were included in the study. After resection, the pathological examination was performed to identify patients with positive
CRM and/or LRM. Relations between the different pathological parameters and the CMR and LRM involvements were assessed.
Results. Positive CRM was present in 17 cases (34%), while positive LRM was found in 6 cases (12%). )e involvement of both
margins was significantly associated with rectal tumors and tumors with infiltrative gross appearance, grade III, deeper invasion,
and positive lymph node metastases. Also, there was a significant association between both margins’ positivity and other
pathological parameters as signet ring carcinoma, tumor budding, perineural and vascular invasion, high microvessel density
(MVD), and sinusoidal vascular pattern, while the presence of necrosis and infiltrative advancing tumor front was significantly
associated with CRM involvement only. )e depth of tumor invasion and signet ring carcinoma were identified as independent
predictor factors for positive CRM and LRM, respectively. Conclusion. Preoperative identification of these pathological parameters
can be a guide to tailor the management plan accordingly. |
