Authors
Muhammad Hammad Ur Rehman, Mariam Asad, Mehrub Munawar, Haider Abid, Zubair Shabbir Khanzada
Published in
BMC surgery. Jul 13, 2026. Epub Jul 13, 2026.
Abstract
The prognostic value of circumferential resection margin (CRM) width after neoadjuvant-treated esophagectomy remains uncertain.
To assess whether CRM distance predicts early (12-month) locoregional recurrence (LRR) following hybrid Ivor-Lewis esophagectomy.
Retrospective observational cohort at a tertiary cancer center, April 2023-October 2024.
Consecutive adults who underwent two-stage (hybrid) esophagectomy for malignancy; emergencies and abandoned resections excluded.
Pathologic CRM measured in millimeters, analyzed continuously and by RCPath thresholds (≤ 1 mm vs. > 1 mm).
Primary-12-month locoregional recurrence (LRR). Secondary-any recurrence and recurrence-free survival (RFS).
Sixty-three resections were analyzed. CRM was measurable in 45 (71.4%). Median CRM was 2.0 mm (IQR 1.0-3.0). Six patients (9.5%) developed recurrence within 12 months-five locoregional and one distant. One of twenty-nine pathological complete responders (pCR, 3.4%) recurred. Univariable analysis did not demonstrate a significant association between CRM distance and early recurrence. Kaplan-Meier analysis showed no statistically significant difference in recurrence-free survival between CRM categories.
Early recurrence occurred in 9.5% of patients, predominantly locoregional. CRM distance, whether analyzed continuously or using RCPath thresholds, was not associated with early recurrence. These findings suggest that, within this single-center cohort, early relapse may reflect underlying tumor biology rather than marginal radial clearance, although results should be interpreted with caution given limited event numbers.
PMID:
42443838
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.
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