Which of the following statements with regard to resection of rectal cancers is/are true?

b. A distal margin of 3 cm should be obtained because only 3% of patients have microscopic evidence of intramural spread beyond 2 cm from the palpable tumor

d. There is no correlation between local recurrence and distal margins beyond 2 cm

One of the controversies surrounding sphincter-saving procedures for rectal tumors is the length of adequate distal mucosal margin. The traditional dictum of 5 cm for a margin is not substantiated by any studies. Only 2.5% of patients have intramural spread beyond 2 cm from the palpable tumor, and these patients generally have dissemination of tumor despite aggressive local therapy. There is no correlation between local recurrence and the extent of distal margin when it is greater than 2 cm. Ideally, a surgical margin of 3 cm, measured on the fresh specimen, should be achieved.