Skip to main content
Top

Open Access 08-07-2024 | Rectal Cancer | Original Article

Measurement of the distance between tumor micro-foci and gross tumor in rectal cancer pathological specimens: implication on margin distance of clinical target volume treated with high-dose radiotherapy for rectal cancer

Authors: Xu-Jie Bao, Xiao-Yan Chen, Lu Wen, Yuan-Yuan Liu, En-Hao Yu, Zheng Wu, Ke Liu, Ju-Mei Zhou, Su-Yu Zhu

Published in: International Journal of Clinical Oncology

Login to get access

Abstract

Purpose

To measure the micro-foci distance away from gross tumor and to provide reference to create the clinical target volume (CTV) margin for boost radiotherapy in rectal adenocarcinoma.

Methods

Twenty-eight rectal cancer surgical specimens of only total mesorectal excision were collected. The pathological specimens were retrospectively measured, and the nearest distance between the tumor micro-foci and gross tumor was microscopically measured. The “in vivo–in vitro” retraction factor was calculated as the ratio of the deepest thickness laterally and the vertical height superior/inferiorly of the rectal tumor measured in MRI and those measured in immediate pathological specimens. The retraction factor during pathological specimen processing was calculated as the distance ratio before and after dehydration in the lateral, superior, and inferior sides by the “knot marking method.” The distances of tumor micro-foci were individually corrected with these two retraction factors.

Results

The mean “in vivo–in vitro” tumor retraction factors were 0.913 peripherally and 0.920 superior/inferiorly. The mean tumor specimen processing retraction factors were 0.804 peripherally, 0.815 inferiorly, and 0.789 superiorly. Of 28 patients, 14 cases (50.0%) had 24 lateral micro-foci, 8 cases (28.6%) had 13 inferior micro-foci, and 7 cases (25.0%) had 19 superior micro-foci. The 95th percentiles of the micro-foci distance for 28 patients were 6.44 mm (peripheral), 5.54 mm (inferior), and 5.42 mm (superior) after retraction correction.

Conclusion

The micro-foci distances of 95% of rectal adenocarcinoma patients examined were within 6.44 mm peripherally, 5.54 mm inferiorly, and 5.42 mm superiorly. These findings provide reference to set the boost radiotherapy CTV margin for rectal cancer.
Literature
5.
go back to reference Dewdney A, Cunningham D, Tabernero J et al (2012) Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C). J Clin Oncol 30:1620–1627. https://doi.org/10.1200/JCO.2011.39.6036CrossRefPubMed Dewdney A, Cunningham D, Tabernero J et al (2012) Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C). J Clin Oncol 30:1620–1627. https://​doi.​org/​10.​1200/​JCO.​2011.​39.​6036CrossRefPubMed
Metadata
Title
Measurement of the distance between tumor micro-foci and gross tumor in rectal cancer pathological specimens: implication on margin distance of clinical target volume treated with high-dose radiotherapy for rectal cancer
Authors
Xu-Jie Bao
Xiao-Yan Chen
Lu Wen
Yuan-Yuan Liu
En-Hao Yu
Zheng Wu
Ke Liu
Ju-Mei Zhou
Su-Yu Zhu
Publication date
08-07-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-024-02582-4