Objective: To determine an adequate distal bowel length to be excised for safe surgical removal of rectal carcinoma.
Methods: p53 expression and patterns of cancer cell invasion into the bowel wall distal to the tumors were studied in 68 surgically removed rectal carcinoma specimens with immunohistochemical and routine pathological methods respectively.
Results: In 52.9% (36/68) of the cases, cancer cell infiltration in the bowel was found microscopically, among which 32 (88.9%) had the infiltration confined within 2 cm from the primary tumors, with the rest cases within 3 cm. The scope of the distal infiltration of the cancer cells was correlated to the gross morphology, histological type and Dukes' stages of the primary tumors. Of the 16 cases (23.5%) positive for p53 expression in the distal bowel mucosa, 13 had p53 expression profile detected within 2 cm, all within 3 cm. The expression of p53 in the distal bowel mucosa was not correlated with the clinical and pathological features of the primary rectal carcinoma.
Conclusion: Excision till the compromised bowel 3 cm distal to the tumor may ensure safe removal of rectal cancer.