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A uniform residual tumor (R) classification
Integration of the R classification and the circumferential margin status
Article first published online: 17 JUN 2009
Copyright © 2009 American Cancer Society
Volume 115, Issue 15, pages 3483–3488, 1 August 2009
How to Cite
Wittekind, C., Compton, C., Quirke, P., Nagtegaal, I., Merkel, S., Hermanek, P. and Sobin, L. H. (2009), A uniform residual tumor (R) classification. Cancer, 115: 3483–3488. doi: 10.1002/cncr.24320
- Issue published online: 20 JUL 2009
- Article first published online: 17 JUN 2009
- Manuscript Accepted: 20 NOV 2008
- Manuscript Received: 9 OCT 2008
- circumferential resection margin;
- International Union Against Cancer;
- rectal carcinoma;
- residual tumor (R) classification
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”).
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.
To avoid confusion by different definitions, the authors proposed including the minimal distance between tumor and resection margin into the current R classification.
By using the proposed expanded classification, comparisons of new data with previous publications will be possible. Cancer 2009. © 2009 American Cancer Society.