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Preoperative computed tomography assessment of circumferential resection margin in retroperitonealized colon cancer predicts disease-free survival

 Nieun Seo  ;  Joon Seok Lim  ;  Taek Chung  ;  Jong Min Lee  ;  Byung Soh Min  ;  Myeong-Jin Kim 
 EUROPEAN RADIOLOGY, Vol.33(4) : 2757-2767, 2023-04 
Journal Title
Issue Date
Colonic Neoplasms* / diagnostic imaging ; Colonic Neoplasms* / pathology ; Colonic Neoplasms* / surgery ; Disease-Free Survival ; Humans ; Male ; Margins of Excision ; Middle Aged ; Neoplasm Recurrence, Local / pathology ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms* / pathology ; Retrospective Studies ; Tomography
Colon cancer ; Disease-free survival ; Margins of excision ; Tomography, X-ray computed
Objectives The aim of this retrospective study was to predict circumferential resection margin (CRM) involvement on preoperative

CT, and prognostic impact of CRM assessment by CT (ctCRM) in patients with retroperitonealized colon cancer.

Methods This study included patients who underwent resection for ascending or descending colon cancer between July 2010 and

February 2013. Positive ctCRM was defined as tumor distance to the retromesenteric plane of ≤ 1 mm. The origin of positive

CRM was divided into primary tumor or other tumor components including lymph nodes, tumor deposits, or extramural venous

invasions. Logistic regression analysis was performed to identify preoperative factors to predict pathologic CRM (pCRM). A

Cox proportional hazards model was used in multivariable analysis to determine the preoperative factors affecting disease-free

survival (DFS).

Results A total of 274 patients (mean age, 64.0 years ± 11.0 [standard deviation]; 157 men) with retroperitonealized colon cancer

were evaluated. Of 274 patients, 67 patients (24.5%) had positive CRM on surgical pathology. The accuracy of preoperative CT

in predicting pCRM was 79.6% (218/274). Among preoperative factors, only CRM assessment on CT was independently

associated with pCRM (p < 0.001). Positive ctCRM by primary tumor was an independent factor for DFS (HR, 3.362 [1.714–

6.593]) and systemic recurrence (HR, 3.715 [1.787–7.724], but not for local recurrence on multivariable analyses.

Conclusions Preoperative CT can accurately predict pCRM, and positive ctCRMby primary tumor is an independent risk factor

for DFS and systemic recurrence, but not for local recurrence in retroperitonealized colon cancer.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
Lee, Jong Min(이종민) ORCID logo https://orcid.org/0000-0003-1654-1533
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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