Academic Journal
Macroscopic assessment of mesorectal excision in rectal cancer: a useful tool for improving quality control in a multidisciplinary team
| العنوان: | Macroscopic assessment of mesorectal excision in rectal cancer: a useful tool for improving quality control in a multidisciplinary team |
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| المؤلفون: | García-Granero Ximénez, Eduardo, Faiz, Omar, Muñoz Forner, E., Flor Lorente, Blas, Navarro Fos, Samuel, Faus, Carmen, García Botello, Stephanie Anne, Lledó Matoses, Salvador, Cervantes Ruipérez, Andrés |
| المصدر: | García-Granero Ximénez, Eduardo Faiz, Omar Muñoz Forner, E. Flor Lorente, Blas Navarro Fos, Samuel Faus, Carmen García Botello, Stephanie Anne Lledó Matoses, Salvador Cervantes Ruipérez, Andrés 2009 Macroscopic assessment of mesorectal excision in rectal cancer: a useful tool for improving quality control in a multidisciplinary team. Cancer 115 15 3400 3411 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2024 |
| المجموعة: | Universitat de València: Roderic - Repositorio de contenido libre |
| مصطلحات موضوعية: | cirurgia, càncer cirurgia |
| الوصف: | Background: High quality of surgical technique and the use of descriptive measures to assess and report surgical proficiency have been shown to influence locoregional tumor control in patients with rectal cancer. In this study, the authors have aimed to audit the implementation of a macroscopic assessment of mesorectal excision (MAME) and to investigate factors that influenced surgical quality and disease recurrence. Methods: All curative resections for rectal cancer were prospectively evaluated for MAME between 1998 and 2007. Mesorectal specimens were graded into 3 types: complete, nearly complete, and incomplete categories. Univariate and multivariate analyses identified independent risk factors for noncomplete mesorectum categories as well as local and overall tumor recurrence. Results: Of 359 specimens, 294 (81.9%) underwent evaluation; 82.3% were 'complete.' Abdominoperineal resection (APR) was the sole covariate associated with inadequate mesorectal excision (odds ratio [OR]=2.7; P=.003). Independent predictors of local recurrence were circumferential resection margin (CRM) involvement (OR=3.6; P=.027) and noncomplete mesorectum (OR=4.4; P=.008). CRM+ (OR=3.1; P=.004), poorly differentiated tumors (OR=14.2; P=.010), nodal involvement (OR=2.9; P=.010), and APR (OR=2.9; P=.006) were independent risk factors for overall recurrence. In lower third tumors, noncomplete mesorectum occurred more frequently in APR compared with sphincter-saving procedures (31.1% vs 18.8%; P=.088). Conclusions: This study demonstrates the value of auditing MAME. Good proficiency of mesorectal excision is associated with lower tumor recurrences after curative surgery, and is a morphological tool found to be useful in clinical practice. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0008-543X |
| Relation: | Cancer, 2009, vol. 115, num. 15, p. 3400-3411; García‐Granero, E., Faiz, O., Muñoz, E., Flor, B., Navarro, S., Faus, C., García‐Botello, S. A., Lledó, S., & Cervantes, A. (2009). Macroscopic assessment of mesorectal excision in rectal cancer. En Cancer (Vol. 115, Issue 15, pp. 3400-3411). Wiley. https://doi.org/10.1002/cncr.24387; https://hdl.handle.net/10550/98150; 054613 |
| DOI: | 10.1002/cncr.24387 |
| الاتاحة: | https://hdl.handle.net/10550/98150 https://doi.org/10.1002/cncr.24387 |
| Rights: | metadata only access |
| رقم الانضمام: | edsbas.67C0BB8C |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 0008543X |
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| DOI: | 10.1002/cncr.24387 |