Wray CJ, Lowy AM, Matthews JB, James LE, Mammen JM, Choe KA, Hanto DW, Ahmad SA. Intraoperative margin re-resection for colorectal liver metastases.
JOURNAL OF SURGICAL EDUCATION 2007;
64:150-7. [PMID:
17574176 DOI:
10.1016/j.jsurg.2007.03.001]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Revised: 02/14/2007] [Accepted: 03/01/2007] [Indexed: 05/15/2023]
Abstract
OBJECTIVE
Evaluate recurrence and survival in patients who underwent intraoperative margin re-resection for colorectal cancer liver (CRC) metastases.
DESIGN
Retrospective analysis.
SETTING
University Hospital, Cincinnati, Ohio. Academic medical center.
PARTICIPANTS
Cohort of 118 patients who underwent resection of CRC liver metastases between 1992 and 2004. All patients were divided into 3 groups: resection margin (MOR) less than 1 cm (n = 64), MOR greater than 1 cm (n = 33), and re-resection margin (re-MOR) greater than 1 cm (n = 21).
RESULTS
Patients with a margin greater than 1 cm, when compared with re-MOR greater than 1 had decreased incidence of liver and distant recurrence (p < 0.05) as well as improved disease-free survival (39.2 vs 22.9 months, p = 0.023). Differences in overall survival (58.6 vs 44.2 months, p = 0.14) were not significant.
CONCLUSION
Intraoperative re-resection is associated with an increased risk of local and distant recurrence, which may be a reflection of both inadequate surgery and underlying tumor biology.
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