Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer

Moustafa Moussally; Maysoon M. GamalEldin; James E. Lapinski; Kathryn Willner; Joseph A. Trunzo; Bradley J. Champagne; Kristen A. Ban; Scott R. Steele; David Liska; Emre Gorgun; David R. Rosen

doi:10.1016/j.amjsurg.2024.115804

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Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer

Journal article

Peer reviewed

Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer

Moustafa Moussally, Maysoon M. GamalEldin, James E. Lapinski, Kathryn Willner, Joseph A. Trunzo, Bradley J. Champagne, Kristen A. Ban, Scott R. Steele, David Liska, Emre Gorgun, …

The American journal of surgery, Vol.237, p.115804

11/2024

DOI: 10.1016/j.amjsurg.2024.115804

PMID: 38925993

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Abstract

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. 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. 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. 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. •The risk of colon cancer recurrence with close margin of adverse histologic factors is unknown.•Our study does not show an increased risk of locoregional recurrence from close margins to adverse histologic features.•The presence of adverse histologic factors within 1 mm of a margin tends to be associated with advanced disease.

Colon cancer

Histologic factors

Locoregional recurrence

Margins

Details

Title: Subtitle: Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer
Creators: Moustafa Moussally - Cleveland Clinic
Maysoon M. GamalEldin - Cleveland Clinic
James E. Lapinski - Cleveland Clinic
Kathryn Willner - Cleveland Clinic
Joseph A. Trunzo - Cleveland Clinic
Bradley J. Champagne - Cleveland Clinic
Kristen A. Ban - Cleveland Clinic
Scott R. Steele - Cleveland Clinic
David Liska - Cleveland Clinic
Emre Gorgun - Cleveland Clinic
David R. Rosen - Cleveland Clinic
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.237, p.115804
DOI: 10.1016/j.amjsurg.2024.115804
PMID: 38925993
NLM abbreviation: Am J Surg
ISSN: 0002-9610
eISSN: 1879-1883
Publisher: Elsevier Inc
Language: English
Date published: 11/2024
Academic Unit: Surgery
Record Identifier: 9984966751302771

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