Surgical Margins during Hepatic Surgery for Colorectal Liver Metastases: Complete Resection not Millimeters Defines Outcome

摘要

Several recent studies have indicated that a margin less than 1 cm is not a contraindication to resection of colorectal liver metastases (CLM).1"3 In the one study2 that appropriately excluded from analyses those patients with positive margins, only number of metastases and extrahepatic disease - not margin width less than 1 cm - predicted outcome. In our own series of 557 patients undergoing resection of CLM, patients with a less-than-5-mm negative margin who underwent resection infrequently experienced recurrence locally (5%). Of note, the incidence of local recurrence was similarly uncommon (11%) in patients resected who had positive margins. Important, however, was the , finding that only 17%ofpatientswithapositive margin were alive after 5 years