A uniform residual tumor (R) classification: Integration of the R classification and the circumferential margin status

Christian Wittekind, Carolyn Compton, Phil Quirke, Iris Nagtegaal, Susanne Merkel, Paul Hermanek, Leslie H. Sobin

Research output: Contribution to journalArticlepeer-review

135 Scopus citations

Abstract

BACKGROUND: Since the introduction of the TNM residual tumor (R) classification, the involvement of resection margins has been defined either as a microscopic (R1) or a macroscopic (R2) demonstration of tumor directly at the resection margin ("tumor transected"). METHODS: The recognition of the importance of the circumferential resection margin (CRM) in patients with rectal cancer patients raises the need for an alternative definition of resection margin involvement, namely, the importance of delineating tumor with a minimal distance from the CRM of ≤1 mm (CRM-positive) from tumor directly at the resection margin. The different use of both definitions of resection margin involvement prevents valid comparisons between reports on treatment results. RESULTS: To avoid confusion by different definitions, the authors proposed including the minimal distance between tumor and resection margin into the current R classification. CONCLUSIONS: By using the proposed expanded classification, comparisons of new data with previous publications will be possible.

Original languageEnglish (US)
Pages (from-to)3483-3488
Number of pages6
JournalCancer
Volume115
Issue number15
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Keywords

  • Circumferential resection margin
  • International Union Against Cancer
  • Rectal carcinoma
  • Residual tumor (R) classification

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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