Fifty colorectal carcinomas were Investigated to demonstrate distal intramural spread (DIS). In 17 cases (34 %) a DIS ranging from 0.25 to 3.5 cm was present. DIS was positively correlated with stage C2 (p < 0.01), lymph node metastasis (p < 0.03) and Infiltrative growth of the tumor (p < 0.05). Our results show that DIS is a relatively frequent event but of limited extension. In fact, a distal clearance margin of 2 cm was considered safe for all patients but one C2 mucoid case. No pathologic feature can predict preoperatively the presence and extent of DIS.
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