Impact of VM Distance on T1 CRC Recurrence Risk

A vertical margin (VM) distance of less than 500 µm has been identified as a risk factor for recurrence in patients with T1 colorectal carcinoma (CRC) who have undergone endoscopic resection.

Fumiaki Tanino and the team aimed to evaluate the impact of VM distance on recurrence rates and prognosis in patients with T1 CRC.

Researchers included 168 patients with T1 CRC who had additional surgery after endoscopic submucosal dissection (ESD) from 2008 to 2016, with a minimum follow-up of 5 years. The researchers compared these groups’ clinicopathological features, recurrence rates, and prognoses using propensity-score matching (PSM).

The patients were divided into 2 groups: those with a VM distance of < 500 µm (n=72, 43% of all patients) and those with a VM distance of 500 µm or more (n=96, 57% of all patients).

The result showed that out of 168 patients, 8 (5%) patients with a VM distance of less than 500 µm experienced tumor recurrence. After matching the groups, the overall and local recurrence rates were significantly higher in the group with a VM distance of less than 500 µm compared to those with 500 µm or more. The 5-year recurrence-free survival (RFS) rate was notably higher in the group with a VM distance of 500 µm or more (100% vs. 89%, P < 0.012).

The study concluded that complete en bloc resection of T1 CRC via ESD should include adequate submucosal tissue to minimize the risk of metastasis and recurrence following additional surgery.

The study received open access funding by Hiroshima University.

Source: https://pubmed.ncbi.nlm.nih.gov/39150588/

Tanino F, Yamashita K, Nagata S, et al. (2024). “Vertical margin distance in T1 colorectal carcinoma resected by endoscopic submucosal dissection affects prognosis after additional surgery.” Int J Colorectal Dis. 2024 Aug 16;39(1):134. doi: 10.1007/s00384-024-04700-0. PMID: 39150588; PMCID: PMC11329615.