METHODS: A retrospective review of all colon cancer surgical resections for adenocarcinoma from 2007 to 2020 was performed. Inclusion criteria were specimens with a negative primary tumor margin but a close margin of adverse histologic factors, defined as intravascular tumor, intranodal tumor, tumor deposits, or extranodal extension within 1 mm of a mesenteric or circumferential margin.
RESULTS: Among 4435 pathology reports reviewed, 45 (1 %) of cases met inclusion criteria. Average follow-up was 38 months. The adverse histologic factor was identified as intranodal tumor in 24 (53 %) cases, intravascular tumor in 8 (17.8 %), tumor deposits in 5 (11.1 %), and more than one pathologic feature in 6 (13.3 %). There were 9 (20 %) recurrences; 6 (13 %) had distant recurrences only, 2 (4 %) patients had locoregional recurrences only, and 1 (2 %) patient had both locoregional and distant recurrence. The adverse histologic factor in these three patients was intravascular in two and both intravascular and intranodal in one.
CONCLUSIONS: Based on our results, we do not have evidence that the presence of intravascular tumor, intranodal tumor, tumor deposits, or extranodal extension within 1 mm of a mesenteric or circumferential margin is associated with increased risk of locoregional recurrence.
方法:回顾性回顾了2007年至2020年所有结肠癌腺癌手术切除。纳入标准是原发肿瘤切缘阴性,但有不良组织学因素的切缘标本。定义为血管内肿瘤,结节内肿瘤,肿瘤沉积物,或在肠系膜或圆周边缘1毫米内的结外延伸。
结果:在4435例病理报告中,45例(1%)符合纳入标准。平均随访38个月。在24例(53%)中,不良组织学因素被确定为结内肿瘤,8例血管内肿瘤(17.8%),肿瘤沉积在5(11.1%),6人中有一个以上的病理特征(13.3%)。有9例(20%)复发;6例(13%)仅有远处复发,2例(4%)患者仅局部复发,1例(2%)患者局部复发和远处复发。这三名患者的不良组织学因素是血管内的两个,血管内和结内的一个。
结论:根据我们的结果,我们没有证据表明血管内肿瘤的存在,结节内肿瘤,肿瘤沉积物,肠系膜或环周边缘1毫米内或结外延伸与局部复发风险增加相关。