SURGICAL MARGIN SIZE IN HEPATIC RESECTIONS FOR COLORECTAL METASTASIS: IMPACT ON RECURRENCE AND SURVIVAL

摘要

Background: Approximately 50 of the patients with a colorectal tumor develop liver metastasis, for which hepatectomy is the standard care. Several prognostic factors have been discussed, among which is the surgical margin. This is a recurring issue, since no consensus exists as to the minimum required distance between the metastatic nodule and the liver transection line. Aim: To evaluate the surgical margins in liver resections for colorectal metastases and their correlation with local recurrence and survival. Methods: A retrospective study based on the review of the medical records of 91 patients who underwent resection of liver metastases of colorectal cancer. A histopathological review was performed of all the cases; the smallest surgical margin was verified, and the late outcome of recurrence and survival was evaluated. Results: No statistical difference was found in recurrence rates and overall survival between the patients with negative or positive margins (R0 versus R1); likewise, there was no statistical difference between subcentimeter margins and those greater than 1 cm. The disease-free survival of the patients with microscopically positive margins was significantly worse than that of the patients with negative margins. The uni-and multivariate analyses did not establish the surgical margin (R1, narrow or less than 1 cm) as a risk factor for recurrence. Conclusion: The resections of liver metastases with negative margins, independently of the margin width, had no impact on tumor recurrence (intra-or extrahepatic) or patient survival.