A uniform residual tumor (R) classification |
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Authors: | Christian Wittekind MD Carolyn Compton MD Phil Quirke MD Iris Nagtegaal MD Susanne Merkel MD Paul Hermanek MD Leslie H. Sobin MD |
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Affiliation: | 1. Institute of Pathology, University Clinic Leipzig, Leipzig, Germany;2. Fax: (011) 49 341 9715009;3. Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland;4. Leeds Institute of Molecular Medicine, University of Leeds, St. James' University Hospital, Leeds, United Kingdom;5. Department of Histopathology and Molecular Pathology, Institute of Pathology, Leeds General Infirmary, Leeds, United Kingdom;6. Department of Pathology, University of Nijmegen, Nijmegen, Netherlands;7. Department of Surgery, University of Erlangen‐Nurnberg, Nurnberg, Germany;8. Division of Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, District of Columbia |
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Abstract: | BACKGROUND: Since the introduction of the TNM residual tumor (R) classification, the involvement of resection margins has been defined either as a microscopic (R1) or a macroscopic (R2) demonstration of tumor directly at the resection margin (“tumor transected”). METHODS: The recognition of the importance of the circumferential resection margin (CRM) in patients with rectal cancer patients raises the need for an alternative definition of resection margin involvement, namely, the importance of delineating tumor with a minimal distance from the CRM of ≤1 mm (CRM‐positive) from tumor directly at the resection margin. The different use of both definitions of resection margin involvement prevents valid comparisons between reports on treatment results. RESULTS: To avoid confusion by different definitions, the authors proposed including the minimal distance between tumor and resection margin into the current R classification. CONCLUSIONS: By using the proposed expanded classification, comparisons of new data with previous publications will be possible. Cancer 2009. © 2009 American Cancer Society. |
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Keywords: | circumferential resection margin International Union Against Cancer rectal carcinoma residual tumor (R) classification |
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