What is a circumferential resection margin?

INTRODUCTION. Circumferential resection margin (CRM) is the closest distance between the radial resection margin and the tumor tissue by either direct tumor spread, areas of neural or vascular invasion, or the nearest involved lymph node.

What is resection margin in cancer?

A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called “resected”, in surgical oncology.

What is radial resection margin?

The circumferential resection margin (crm), also called the radial margin, is very important in rectal cancer surgery, being a prognostic factor in patients who undergo such surgery.

What is proximal resection margin?

Proximal resection margin status was assessed based on the presence of microscopic residual cancer cells. A positive resection margin was defined as the presence of microscopic residual cancer cells at the proximal resection line.

What is a circumferential tumor?

The circumferential extent of a tumor is one factor that represents the amount and invasion area of a rectal cancer. A circumferential extent of a tumor of 75% or more has been shown to be a risk factor for the intramural distal spread of rectal cancer.

What are margins in surgery?

Listen to pronunciation. (MAR-jin) The edge or border of the tissue removed in cancer surgery. The margin is described as negative or clean when the pathologist finds no cancer cells at the edge of the tissue, suggesting that all of the cancer has been removed.

What is marginal resection?

Marginal resection, defined as plane of dissection through the pseudocapsule or peritumoral reactive tissue, removes the gross tumor with 1 cm of normal surrounding soft tissue and 2 to 3 cm of normal surrounding bone tissue.

What are positive surgical margins?

A positive surgical margin is ‘defined as tumor extending to the inked-surface or margin of the prostate’ and is determined by the pathologist. One can think of this situation as removing an orange where the peel is the capsule of the prostate and the fruit is the cancer.

What stage is poorly differentiated carcinoma?

Grade 3: Cancer cells and tissue look very abnormal. These cancers are considered poorly differentiated, since they no longer have an architectural structure or pattern. Grade 3 tumors are considered high grade. Grade 4: These undifferentiated cancers have the most abnormal looking cells.

What is a deep margin?

DEEP MARGIN: Involved by invasive melanoma. Margins are the edge of a biopsy or surgical excision specimen. If melanoma extends to the edge of the sample (the margins), then it is presumed that the biopsy or excision did not remove the entire tumor.

What is a negative surgical margin?

What does it mean when the margins are not clear?

A clear, negative, or clean margin means there are no cancer cells at the outer edge of tissue that was removed. A positive margin means that cancer cells come right out to the edge of the removed tissue and have ink on them.

What is a positive surgical margin?

A positive surgical margin at prostatectomy is defined as tumor cells touching the inked edge of the specimen. This finding is reported in 8.8% to 42% of cases (median about 20%) in various studies.

What are acceptable margins?

But in general, a healthy profit margin for a small business tends to range anywhere between 7% to 10%. Keep in mind, though, that certain businesses may see lower margins, such as retail or food-related companies. That’s because they tend to have higher overhead costs.

Is poorly differentiated malignant tumor curable?

It is now clear that some patients with poorly differentiated carcinoma of unknown primary site have extremely responsive neoplasms, and some are curable with combination chemotherapy.

Is a 5 mm tumor big?

T1a is a tumor that is larger than 1 mm but 5 mm or smaller. T1b is a tumor that is larger than 5 mm but 10 mm or smaller. T1c is a tumor that is larger than 10 mm but 20 mm or smaller.

What is a positive margin?

The margin is described as positive or involved when the pathologist finds cancer cells at the edge of the tissue, suggesting that all of the cancer has not been removed.

What is circumferential resection margin?

Circumferential resection margin. A margin of ≤1 mm is considered by some to be a negative prognostic factor for local recurrence 2. The prognostic value of the CRM has been called into question in some recent studies 3. The CRM is not valid for excised colon covered by a peritoneal lining.

Is the resection margin on the excised rectum a prognostic factor?

Pathologic evaluation of the resection margin on the excised rectum has been considered important for determining the risk of local recurrence. A margin of ≤1 mm is considered by some to be a negative prognostic factor for local recurrence 2.

What is the maximum margin involved in rectal cancer recurrence?

Nagtegaal ID, Marijnen CA, Kranenbarg EK, et al. Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. Am J Surg Pathol. 2002;26:350–357. doi: 10.1097/00000478-200203000-00009.

Is R-1 resection an independent predictor of DFS after oncologic esophagectomy?

Although R status is an independent predictor of DFS after oncologic esophagectomy, the < 0.1-cm definition for R 1 resection seems more appropriate than the 0.0-cm definition as an indicator of poor tumor biology, long-term recurrence, and survival. The online version contains supplementary material available at 10.1245/s10434-021-10121-y.