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Updated: Jul 18, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
[Patterns and prognostic value of resection margin involvement and lateral pelvic metastases for patients with rectal
Cun Wang1, Zong-guang Zhou, Dan Xu
1Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Objective:
To study the patterns and prognostic value of resection margin involvement and lateral pelvic metastases, providing surgeons with pathologic proofs of tumor spread within the studied areas.
Methods:
Large tissue slices of 62 specimens from patients with rectal cancer were used in the pathologic study and the outcomes were followed.
Results:
Compared with patients without margin involvement, patients with circumferential margin involvement (CMI), seen in 8 cases (12.9%), had poorer postoperative survival (P=0.003). The 12 patients (19.4%) with lateral pelvic metastases suffered poorer survival, compared with those without lateral pelvic metastases (P=0.026). Eight patients (66.7%) were diagnosed to have single lateral pelvic region involved, while the other 4 had multiple regions involved. The incidence of lateral metastases differed among regions, with higher occurrence in the root of middle rectal artery (6/12, 50.0%), area of the internal iliac artery (4/12, 33.3%) and the obturator region (3/12, 25.0%).
Conclusion:
Occurrence of CMI or lateral metastases in rectal cancer patients predispose poor survival, thus a more radical clearance and postoperative adjuvant therapy are recommended.
