Abstract：
OBJECTIVE: Locoregional recurrence after resection of colon cancer is increased when primary tumor margin is positive (<1 mm). Data is limited regarding the risk of locoregional recurrence with close margin (<1 mm) of histologic factors, such as intravascular tumor, intranodal tumor, tumor deposits, or extranodal extension. We hypothesized that close margin of these factors doesn\'t affect locoregional recurrence.
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.
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.
摘要：
目的：当原发肿瘤切缘阳性（<1mm）时，结肠癌切除术后局部复发增加。关于局部复发风险的数据有限，组织学因素的边缘接近（<1毫米），如血管内肿瘤，结节内肿瘤，肿瘤沉积物,或结外延伸。我们假设这些因素的边缘不影响局部复发。
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。
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。
