• İlter Özer, Neslihan İnci Zengin, Hacı Murat Çaycı, Adem Yüksel, Tahsin Dalgıç, Murat Ulaş, Erdal Birol Bostancı, and Musa Akoğlu.
• Department of Gastroenterological Surgery, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey.
• Turk J Med Sci. 2021 Dec 13; 51 (6): 297829852978-2985.

Background/Aim/AimThis study aimed to evaluate the regression pattern with the distal intramural spread (DIS) of rectum cancer after preoperative chemoradiation.Materials And MethodsSpecimens from 56 patients who underwent radical resection after preoperative chemoradiation for rectal cancer were examined. The regression pattern (total, fragmented) of the tumor was recorded. DIS status was evaluated by creating sections 0.2 to 0.3 cm thick.ResultsA single macroscopic residual area was detected in all specimens. In 10 patients (17.8 %), pathologically complete responses were identified, and DIS was detected in 33 patients (58.9%). The average DIS distance was 0.56± 0.3 cm (range 0.2 – 1.8 cm); the spread was < 1 cm in 87.9% of the patients (29/33). The overall survival rates for 5 and 7 years were 76.8% and 73.2%, respectively. The survival rates between patients with and without DIS were not statistically different (94.6± 5.5 vs. 75.1 ± 10.2 months, respectively). In all of the patients, tumor regression pattern was total shrinkage of the tumor.ConclusionA sufficient distal resection margin for rectal cancer after preoperative chemoradiation is 1 cm in the vast majority of cases. However, DIS may exceed 1 cm in a small proportion of patients.This work is licensed under a Creative Commons Attribution 4.0 International License.

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