DISTAL SPREAD IN COLORECTAL TUMORS
ZAFER MALAZGİRT, FİLİZ KARAGÖZ, SALİM GÜMÜŞ, İLKSER AKPOLAT, NECATİ ÖZEN, BEDRİ KANDEMİR, KAYHAN ÖZKAN
Ondokuz Mayıs Üniversitesi, Genel Cerrahi, Patoloji ABD, SAMSUN
The distal intramural and extramural spreads of colorectal cancer were prospectively sought in freshly resected colorectal cancer specimens. The distal microscopic spread in colon and rectum cancer is an important factor. Studies dealt with distal margin have misleading results due to the fact that the dimensions shrink considerably with the formalin fixation. Immediately after surgery, the specimens crucified, and striated according to a scale. The strips consisting of macroscopically the most distally extending portion of the tumors were evaluated pathologically. The findings were compared with parameters related to the patient and the tumor. Distal spread was found in 35 (77.8%) in a total of45 specimens. The average distal spread was 0.6 cm. While 6 (26.1%) of 23 specimens without lymphatic infiltration (NO) had distal spread over 0.5 cm, more than 50% of N, and 100% of N3specimens had distal spread above average (p<0.05). The intensity of lymphatic infiltration was as definitive as the presence of infiltration. The distal spread was over 0,5 cm in 13 (36.1 %) of 36 NO andN1 specimens. However 8 (88.9%) of 9 patients with N2 and N3 lymph nodes had a long distal margin (p<0.05). Our results showed that a distal margin of 2 cm was sufficient in 43 (95.6%) patients. However, we think that the distal margin should be kept longer in those with lymphatic invasion.
Keywords: COLORECTAL CANCER, DISTAL MARGIN, INTRAMURAL SPREAD, TNM CLASSIFICATION, ANTERIOR RESECTION, FORMALDEHYDE FIXATION