biostudies-literatureShroder MNational Center for Advancing Translational SciencesNational Center for Research ResourcesNCATS NIH HHSNIDDK NIH HHSNational Institute of Diabetes and Digestive and Kidney DiseasesNCRR NIH HHSNational Institutes of HealthU.S. Department of Veterans AffairsUS Department of Veterans Affairs Office of Academic Affiliations532-540https://www.ebi.ac.uk/biostudies/studies/S-EPMC10947808biostudies-literatureUnknown296<h4>Introduction</h4>Circumferential resection margin (CRM) is a key quality metric and predictor of oncologic outcomes and overall survival following surgery for rectal cancer. We aimed to develop a nomogram to identify patients at risk for a positive CRM in the preoperative setting.<h4>Methods</h4>We performed a retrospective evaluation of the National Cancer Database from 2010 to 2014 for patients with clinical stage I-III rectal cancer who underwent total mesorectal excision. Patients were excluded for emergency operation, resection for cancer recurrence, palliative resection, transanal resection, and missing CRM status. The primary outcome was positive CRM. Secondary outcomes included overall survival.<h4>Results</h4>There were 28,790 patients included. 2245 (7.8%) had a positive CRM. Higher tumor grade, lack of neoadjuvant chemotherapy, mucinous/signet tumor histology, open approach, abdominoperineal resection, higher T stage, lymphovascular invasion, and perineural invasion were all significantly associated with positive CRM (P < 0.05) and were included in the nomogram. The C-statistic was 0.703, suggesting a good predictive model.<h4>Conclusions</h4>Positive CRM is associated with specific patient demographics and tumor characteristics. These factors can be used along with preoperative MRI to predict CRM positivity in the preoperative period and plan accordingly.The Journal of surgical researchDevelopment of a Predictive Nomogram for Circumferential Resection Margin in Rectal Cancer Surgery.PMC10947808UL1 TR0022432 UL1 TR000445-06UL1 RR024975UL1 RR024975-01UL1 TR000445K23DK118192K23 DK118192Shroder MFord MMMcChesney SKhan AYe FHopkins MBZhao ZHawkins ATfalseDevelopment of a Predictive Nomogram for Circumferential Resection Margin in Rectal Cancer Surgery.<h4>Introduction</h4>Circumferential resection margin (CRM) is a key quality metric and predictor of oncologic outcomes and overall survival following surgery for rectal cancer. We aimed to develop a nomogram to identify patients at risk for a positive CRM in the preoperative setting.<h4>Methods</h4>We performed a retrospective evaluation of the National Cancer Database from 2010 to 2014 for patients with clinical stage I-III rectal cancer who underwent total mesorectal excision. Patients were excluded for emergency operation, resection for cancer recurrence, palliative resection, transanal resection, and missing CRM status. The primary outcome was positive CRM. Secondary outcomes included overall survival.<h4>Results</h4>There were 28,790 patients included. 2245 (7.8%) had a positive CRM. Higher tumor grade, lack of neoadjuvant chemotherapy, mucinous/signet tumor histology, open approach, abdominoperineal resection, higher T stage, lymphovascular invasion, and perineural invasion were all significantly associated with positive CRM (P < 0.05) and were included in the nomogram. The C-statistic was 0.703, suggesting a good predictive model.<h4>Conclusions</h4>Positive CRM is associated with specific patient demographics and tumor characteristics. These factors can be used along with preoperative MRI to predict CRM positivity in the preoperative period and plan accordingly.2024-01-01T00:00:00Z2024 Apr2025-07-13T03:04:26.122Z2025-07-13T03:04:26.122ZS-EPMC109478083833590110.1016/j.jss.2023.12.047