A 60-year-old man undergoes anterior resection for rectal carcinoma at 7 cm from the anal verge. The pathology report mentions circumferential resection margin (CRM) involvement. What is the clinical significance of this finding?
- A It predicts systemic metastasis but not local recurrence
- B It is associated with high local recurrence risk and poorer overall survival ✓
- C CRM involvement under 1 mm is clinically insignificant
- D It only matters in tumors above the peritoneal reflection
Correct answer: B. It is associated with high local recurrence risk and poorer overall survival
Explanation
Circumferential resection margin (CRM) involvement — defined as tumor within 1 mm of the resection margin — is the single most important pathological predictor of local recurrence in rectal cancer. CRM-positive tumors have local recurrence rates of 20-30% versus <5% for CRM-negative resections. It also correlates with distant metastasis and reduced overall survival. This finding may influence decisions on adjuvant radiotherapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.