ABSTRACT
For rectal cancer, local recurrence following surgical treatment is a grave complication
that occurs in as many as 25% of cases. Pathological examination of the surgical resection
specimen plays a primary role in assessing both the surgery- and tumor-related factors
that contribute to the risk of recurrence. Tumor stage is considered the most accurate
indicator of outcome in rectal cancer overall, but additional pathologic features
that have been shown to have stage-independent prognostic significance include tumor
grade; histologic type; extent of extramural penetration by tumor; neural, venous,
and/or lymphatic invasion; tumor border configuration; and host lymphoid response.
The most powerful predictor of local recurrence and overall outcome in rectal cancer,
however, is the macroscopic quality of the mesorectum in the resection specimen and
the proximity of the tumor to the circumferential (radial) resection margin.
KEYWORD
Rectal cancer - tumor - staging - pathology - mesorectum
