What Is the Prognostic Value of CRM Involvement?
Last century, the major problem in the treatment of rectal cancer was the very high local recurrence rate after surgery. Local recurrence rates of 30–50% were common and resulted in a very poor quality of life and short survival of patients with rectal cancer. Treatment of these local recurrences is difficult and often mutilating. In 1986, the landmark paper by Phil Quirke and others  described that involvement of the radial surgical margin, or circumferential resection margin (CRM), was the main cause of local recurrence. This finding, together with the excellent clinical results by Bill Heald and others with a new surgical technique , total mesorectal excision (TME), caused a major change in the treatment and prognosis of rectal cancer patients.
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