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Clin Colon Rectal Surg 2002; 15(1): 007-016
DOI: 10.1055/s-2002-23563
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Staging of Rectal Cancer and the Pathologist's Role in Assessing the Quality of Rectal Cancer Surgery

Carolyn C. Compton
  • Department of Pathology, McGill University, Montreal, Quebec, Canada
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Publication Date:
03 April 2002 (online)

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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