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. 1989 Oct;42(10):1040–1042. doi: 10.1136/jcp.42.10.1040

Is there any justification for the routine examination of bowel resection margins in colorectal adenocarcinoma?

S S Cross 1, A D Bull 1, J H Smith 1
PMCID: PMC501860  PMID: 2584404

Abstract

The proximal and distal bowel resection margins of 339 specimens of colorectal adenocarcinoma were examined for the presence of tumour. In only five cases was tumour found in a resection margin. In four of these cases macroscopic examination showed that the tumour extended to the resection margin. In the fifth case the tumour was present in the pericolic fat. These results and reported data on the intramural spread of colorectal cancer suggest that examination of bowel resection margins is unnecessary unless the tumour extends to within 2 cm of the resection margin. Examination of the deep radial margins of the tumour and slides to show other prognostic indicators would be a more effective use of histopathological resources.

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Selected References

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  1. BLACK W. A., WAUGH J. M. The intramural extension of carcinoma of the descending colon, sigmoid, and rectosigmoid; a pathologic study. Surg Gynecol Obstet. 1948 Oct;87(4):457–464. [PubMed] [Google Scholar]
  2. Blenkinsopp W. K., Stewart-Brown S., Blesovsky L., Kearney G., Fielding L. P. Histopathology reporting in large bowel cancer. J Clin Pathol. 1981 May;34(5):509–513. doi: 10.1136/jcp.34.5.509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. DUKES C. E., BUSSEY H. J. The spread of rectal cancer and its effect on prognosis. Br J Cancer. 1958 Sep;12(3):309–320. doi: 10.1038/bjc.1958.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Floyd C. E., Stirling C. T., Cohn I., Jr Cancer of the colon, rectum and anus: review of 1,687 cases. Ann Surg. 1966 Jun;163(6):829–837. doi: 10.1097/00000658-196606000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Jass J. R., Atkin W. S., Cuzick J., Bussey H. J., Morson B. C., Northover J. M., Todd I. P. The grading of rectal cancer: historical perspectives and a multivariate analysis of 447 cases. Histopathology. 1986 May;10(5):437–459. doi: 10.1111/j.1365-2559.1986.tb02497.x. [DOI] [PubMed] [Google Scholar]
  6. Jass J. R., Love S. B., Northover J. M. A new prognostic classification of rectal cancer. Lancet. 1987 Jun 6;1(8545):1303–1306. doi: 10.1016/s0140-6736(87)90552-6. [DOI] [PubMed] [Google Scholar]
  7. Jass J. R., Morson B. C. Reporting colorectal cancer. J Clin Pathol. 1987 Sep;40(9):1016–1023. doi: 10.1136/jcp.40.9.1016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Quirke P., Durdey P., Dixon M. F., Williams N. S. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet. 1986 Nov 1;2(8514):996–999. doi: 10.1016/s0140-6736(86)92612-7. [DOI] [PubMed] [Google Scholar]
  9. Talbot I. C., Ritchie S., Leighton M. H., Hughes A. O., Bussey H. J., Morson B. C. The clinical significance of invasion of veins by rectal cancer. Br J Surg. 1980 Jun;67(6):439–442. doi: 10.1002/bjs.1800670619. [DOI] [PubMed] [Google Scholar]
  10. Weese J. L., O'Grady M. G., Ottery F. D. How long is the five centimeter margin? Surg Gynecol Obstet. 1986 Aug;163(2):101–103. [PubMed] [Google Scholar]
  11. Williams N. S., Dixon M. F., Johnston D. Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients' survival. Br J Surg. 1983 Mar;70(3):150–154. doi: 10.1002/bjs.1800700305. [DOI] [PubMed] [Google Scholar]

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