Observational studyInternational journal of colorectal disease2015
Risk factors for circumferential R1 resection after neoadjuvant radiochemotherapy and laparoscopic total mesorectal excision: a study in 233 consecutive patients with mid or low rectal cancer.
Observational study in International journal of colorectal disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Long-term Local Control Following CEA-targeted Fluorescence-guided Surgery in Patients With Locally Advanced and Recurrent Rectal Cancer.Molecular imaging and biology · 2025Trial
- Real-Time Detection of Colorectal Cancer Using Topical Application of a pH-Activatable Fluorophore.Molecular diagnosis & therapy · 2026Article
- Influence of incorrect staging of colorectal carcinoma on oncological outcome: are we playing safely?Updates in surgery · 2022Article
- Operative Approach Does Not Impact Radial Margin Positivity in Distal Rectal Cancer.World journal of surgery · 2021Article
- Delayed surgery after radio-chemotherapy for rectal adenocarcinoma is protective for anastomotic dehiscence: a single-center observational retrospective cohort study.Updates in surgery · 2020Observational
- Fluorescent-guided surgery for sentinel lymph node detection in gastric cancer and carcinoembryonic antigen targeted fluorescent-guided surgery in colorectal and pancreatic cancer.Journal of surgical oncology · 2018Review
- Is There Any Reason Not to Perform Standard Laparoscopic Total Mesorectal Excision?Clinics in colon and rectal surgery · 2017Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to identify risk factors for circumferential R1 resection (R1c) after neoadjuvant radiochemotherapy (RCT) and laparoscopic total mesorectal excision (TME) for mid or low rectal cancer. Better knowledge of pre- or intraoperative risk factors could possibly help for the management of these patients.
methodsBetween 2005 and 2013, 233 consecutive patients undergoing laparoscopic TME for low or mid rectal cancer after RCT were included. R1c resection was defined as a circumferential margin ≤ 1 mm. Univariate and multivariate analyses were performed to identify independent risk factors for R1c.
resultsTwenty-five patients had R1c resection (11%). In univariate analysis, low rectal cancer, anterior tumour, T4 on pretherapeutic magnetic resonance imaging (MRI), T4 and/or N+ on post-RCT MRI and operative time > 240 min were associated with a significantly increased risk of R1c resection. In multivariate analysis, only T4 on post-RCT MRI (odds ratio (OR) = 6.02 [1.06-33]; p = 0.043) and operative time >240 min. (OR = 5.4 [1.01-28.9]; p = 0.049) were identified as independent risk factors for R1c resection. The risk of R1c resection was 3% (n = 3/88), 10% (n = 5/51) or 38% (n = 3/8) when 0, 1 or 2 risk factors were present in the same patient, respectively.
conclusionPatients with T4 on MRI after RCT and/or operative time >240 min. seems to be at higher risk for R1c resection. In a pragmatic approach, we consider that systematic second MRI after RCT could help the surgeon, especially in area where circumferential margin is too short, in order to reduce this risk of R1 resection.
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