The Circumferential Resection Margin Is a Prognostic Predictor in Colon Cancer

Area of Science:

• Oncology
• Surgical Pathology
• Cancer Prognostics

Background:

• Circumferential resection margin (CRM) is a critical prognostic factor in rectal and esophageal cancers.
• Its prognostic value in colon cancer remains less understood.
• This study addresses the significance of CRM in colon cancer prognostication.

Purpose of the Study:

• To evaluate the prognostic value of CRM in colon cancer.
• To identify optimal CRM cutoff values for predicting survival.
• To assess the impact of CRM on overall survival and response to chemotherapy.

Main Methods:

• Utilized data from 6,681 CRM-positive and 25,908 CRM-negative colon cancer patients (2010-2015) from the SEER database.
• Employed statistical analyses including chi-square, Kaplan-Meier, Cox proportional hazards models, and X-tile software.
• Propensity score matching was performed to control for confounding factors.

Main Results:

• CRM positivity was significantly associated with poorer survival (P < 0.001).
• Optimal cutoff values of 0 mm and 30 mm for CRM were identified for stages II-IV.
• Patients with CRM > 30 mm had a 33% reduced risk of mortality; chemotherapy improved overall survival, particularly for those with CRM 0-30 mm.

Conclusions:

• CRM positivity is a strong negative prognostic indicator in colon cancer.
• A CRM of > 30 mm is associated with improved outcomes for stages II-IV.
• Number of regional lymph nodes is a valuable substitute for CRM in stage I, and chemotherapy benefits overall survival.