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Updated: Feb 26, 2026
03:36
Development of Compendium for Esophageal Squamous Cell Carcinoma
Published on: April 12, 2024
874
Does the Margin Matter in Esophageal Cancer
Karl-Frederick Karstens1, Jakob R Izbicki, Matthias Reeh
1Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Digestive Surgery
|July 12, 2017
Summary
Circumferential resection margin (CRM) involvement significantly impacts esophageal cancer (EC) patient survival. The College of American Pathologists (CAP) criteria are recommended for better identification of patients with poor prognosis.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- The prognostic significance of circumferential resection margin (CRM) involvement in resected esophageal cancer (EC) is debated.
- Differing definitions of CRM involvement exist from the College of American Pathologists (CAP) and the Royal College of Pathologists (RCP).
Purpose of the Study:
- To systematically review and evaluate the clinical significance of CRM involvement on patient survival after esophagectomy for EC.
Main Methods:
- A systematic literature search was conducted across PubMed, Science Direct, and Google Scholar.
- Studies analyzing the clinical impact of CRM in esophageal cancer were included.
Main Results:
- Twenty-eight studies were analyzed, reporting a wide range of CRM involvement (8.6-83.1%).
- Both meta-analyses confirmed a significant association between positive CRM and reduced patient survival, regardless of RCP or CAP criteria.
- Neoadjuvant therapy's influence on CRM status remains unclear.
Conclusions:
- CRM involvement is a valuable prognostic indicator for esophageal cancer patients.
- Utilizing CAP criteria is preferred for more effective identification of high-risk patients.
- Neoadjuvant therapy and en bloc transthoracic esophagectomy are associated with achieving a negative CRM.
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