%0 Journal Article
%T Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer.
%A Moussally M
%A GamalEldin MM
%A Lapinski JE
%A Willner K
%A Trunzo JA
%A Champagne BJ
%A Ban KA
%A Steele SR
%A Liska D
%A Gorgun E
%A Rosen DR
%J Am J Surg
%V 0
%N 0
%D 2024 Jun 19
%M 38925993
%F 3.125
%R 10.1016/j.amjsurg.2024.115804
%X 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.