RMPs Prognostic Implications in Pts with Surgically Treated Colon Cancer

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Radial margin positivity (RMP) was associated with recurrence, risk of death, shorter survival, and high rates of conversion and multivisceral resection in patients with colon cancer, according to an article published online in the journal JAMA Surgery.

The study included 984 patients with surgically treated colon cancer, excluding 47 patients with intramucosal tumors, 24 patients with palliative resections, and 16 patients with non-assessable radial margin status.

Results showed 5.3% (52 out of 984) of patients had RMP, and that these patients had increased rates of multivisceral resection (40.4% vs. 12.8%; relative risk, 3.16; 95% CI: 2.18, 4.58; P<0.001) and conversion (50.0% vs. 13.7%; relative risk, 3.78; 95% CI: 1.56, 9.18; P=0.01).

Furthermore, all patients with RMP had stage 2 cancer or higher (according to American Joint Committee on Cancer). This cohort had increased rates of node positivity (86.5% vs. 38.8%; relative risk, 2.23; 95% CI: 1.95, 2.55;<P<0.001), metastasis (34.6% vs. 6.7%; relative risk, 5.20; 95% CI: 3.34-8.11; P<0.001), extramural vascular invasion (76.9% vs. 28.4%; relative risk, 2.71; 95% CI: 2.26, 3.24; P<0.001), and high-grade tumor (45.1% vs. 18.2%; relative risk, 3.01; 95% CI: 2.44, 3.88; P<0.001).

Patients with RMP and without baseline metastasis had greater rates of metastatic disease in follow-ups (37.5% vs. 12.5%; relative risk, 3.32; 95% CI: 2.79, 3.95; P<0.001), especially metastasis of the peritoneum (18.8% vs. 2.6%; relative risk, 7.24; 95% CI: 2.40, 21.8; P<0.001) and liver (18.8% vs. 6%; relative risk, 3.10; 95% CI: 1.08, 8.92; P=0.04).

The study suggests that a timely identification of RMP in patients through preoperative assessments could lead to adequate surgical preparation and therapeutic measures.

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Radial margin positivity associated with recurrence, risk of death, shorter survival in patients with colon cancer.
Although extensively studied for rectal malignancies, radial margin positivity has unclear prognostic implications for tumors of the colon.
READ FULL ARTICLE From archsurg.jamanetwork.com

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