Pathological study of distal mesorectal cancer spread to determine a proper distal resection margin

Table 4 Review of distal mesorectal spread of rectal cancer.

References	Cases (n)	With DMS (n)	Frequency of DMS (%)	Pattern of DMS	Maximum extent of DMS (cm)	Suggested DCM (cm)
Heald et al.[12]	-	5	-	ly, vi, LN	4	TME
Williams et al.[19]	50	3	6	LN	1.3	<5
Scott et al.[10]	20	4	20	ly, D	3	3 to 5
Shirouzu et al.[20]	610	44	7.2	ly, D, LN	≤2	1
Reynolds et al.[7]	50	12	24	LN, foci	5	TME
Hida et al.[21]	198	40	20.2	LN	4	2 cm (lower rectal cancer)
Tocci et al.[11]	53	19	35.1	LN, foci	-	TME
Ono et al.[5]	40	3	7.5	LN	2.4	3

DMS = distal mesorectal spread; DCM= distal resection margin; LN = lymph node metastasis; ly = lymphatic permeation; vi = vessel invasion; D = direct infiltration; foci = neoplastic microfoci.