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AdenoCA of Colon : Surgical Margins

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It is important to get negative margins in colectomy (resection) specimens to improve prognosis. The status of proximal, distal, and radial (circumferential) margins of resection should be documented in the pathology report.

The surgical treatment of colorectal cancer includes total mesorectal resection (TME) defined as sharp resection of the tumor en-bloc along with surrounding pericolic lymphatic tissue as contained within the mesocolon. This approach also removed any unrecognized pericolonic tumoral deposits. It has reduced recurrence rates and improves outcomes.

The image shows positive circumferential margin in a case of colorectal cancer that has extended through all the layers of the specimen. The circumferential resection margin, also referred to as circumferential radial margin or mesenteric margin, is an important prognostic indicator for recurrence.

The distance between the leading edge of the tumor and the nearest edge of the surgically resected margin is recorded to the nearest tenth in millimeters. If the measurement is less than 1 mm, it is considered a positive margin which is associated with a high risk of recurrence and poor survival.

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