Effect of subcentimeter nonpositive resection margin on hepatic recurrence in patients undergoing hepatectomy for colorectal liver metastases. Evidences from 663 liver resections

Figueras, Joan; Burdı́o, Fernando; Ramos, Emilio; Torras, Jaume; Lladó, Laura; López‐Ben, Santiago; Codina-Barreras, Antoni; Mojal, Sergi

doi:10.1093/annonc/mdm106

Cited by 115 publications

(87 citation statements)

References 30 publications

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“…More wedge resections can be performed because several recent studies have indicated that a margin less than 1 cm is not a contraindication to resection of colorectal liver metastases. [22][23][24][25] Moreover, a margin of 1 mm seems to be appropriate, despite the fact that the pathological report will define the procedure as a microscopic irradical resection. 24 Current techniques with ultrasonic dissectors aspirate a part of the liver parenchyma interposed between the specimen and the normal liver, making assessment of the true margin difficult.…”

Section: Discussionmentioning

confidence: 99%

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Pool

Lalmahomed

Wilt

et al. 2009

Journal of Gastrointestinal Surgery

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Objective The objective of the study was to identify patients who may benefit from local treatment in recurrent colorectal liver metastases. Materials and methods A total of 51 consecutive patients were treated for hepatic recurrence(s) after an initial partial hepatic resection. Surgery was considered as the primary treatment option for eligible patients. Patients with a small liver remnant after major hepatectomy were treated with radiofrequency ablation (RFA) or stereotactic body radiation therapy (SRx). SRx was given as an outpatient, emerging local treatment option for patients with intra-hepatic recurrences not eligible for surgery or RFA. Partial liver resection was performed in 36 patients (70%), RFA in ten patients (20%), and SRx in five patients (10%). Results Median hospital stay was 7 (range, 3-62) days with a morbidity of 16% without in-hospital death. None of the patients received adjuvant chemotherapy. There was no difference in recurrence or survival between the three treatment modalities. Overall 5-year survival was 35% with an estimated median survival of 37 months. Patients with a disease-free interval between first hepatectomy and hepatic recurrence less than 6 months did not survive 3 years. Conclusions Resection, RFA, and SRx can be performed safely in patients with recurrent colorectal liver metastases and offer a survival that seems comparable to primary liver resections of colorectal liver metastases.

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Section: Discussionmentioning

confidence: 99%

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Pool

Lalmahomed

Wilt

et al. 2009

Journal of Gastrointestinal Surgery

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“…At the present time the ideal margin is yet to be defined as some authors have shown that negative margins of either 1-4 mm, 5-9 mm or up to 1 cm have similar overall recurrence rates and survival [25][26][27] . In our study differences in recurrence and survival could not be found when comparing free surgical margins under and above 1 cm, a fact that supports these previous observations.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors and time-related changes influence results of colorectal liver metastases surgical treatment: A single-center analysis

Martı́¹,

Modolo²,

Fuster³

et al. 2009

WJG

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AIM: To analyze the prognostic factors involved in survival and cancer recurrence in patients undergoing surgical treatment for colorectal liver metastases (CLM) and to describe the effects of time-related changes on survival and recurrence in these patients. METHODS:From January 1994 to January 2006, 236 patients with CLM underwent surgery with the aim of performing curative resection of neoplastic disease at our institution and 189 (80%) of these patients underwent resection of CLM with curative intention. Preoperative, intraoperative and postoperative data, including primary tumor and CLM pathology results, were retrospectively reviewed. Patients were divided into two time periods: a first period from January 1994 to January 2000 (n = 93), and a second period from February 2000 to January 2006 (n = 143). RESULTS:Global survival at 1, 3 and 5 years in patients undergoing hepatic resection was 91%, 54% and 47%, respectively. Patients with preoperative extrahepatic disease, carcinoembryonic antigen (CEA) levels over 20 ng/dL, more than four nodules or extrahepatic invasion at pathological analysis had worse survival. Tumor recurrence rate at 1 year was 48.3%, being more frequent in patients with preoperative and pathological extrahepatic disease and CEA levels over 20 ng/dL. Although patients in the second time period had more adverse prognostic fa c t o r s , no di ffe re nc e s in ove ra l l s ur v iva l a n d recurrence were observed between the two periods. CONCLUSION:Despite advances in surgical technique and better adjuvant treatments and preoperative imaging, careful patient staging and selection is crucial to continue offering a chance of cure to patients with CLM.

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“…In spite of some conflicting reports, evidence shows that size is not a resectability factor, but a factor related to the aggressiveness of the tumour. Likewise, the width of the surgical margin has no effect on survival providing that the margin is microscopically negative [128][129][130] , though resection should attempt to get an optimum margin.…”

Section: Resectabilitymentioning

confidence: 99%

Metastatic lesions to the liver: Surgical indications and techniques

Tejedor¹,

Serrablo²

2013

JST

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Background: Although there is an established agreement on the advantage of liver resection for metastatic colorectal and neuroendocrine tumours, the role of hepatic surgery in patients with liver metastases from non-colorectal and non-neuroendocrine carcinoma is not well defined. In recent years, despite the poor results, liver metastases suitable for surgery have been treated with resection. The results reported in recent studies support a developing trend toward surgery in this setting. Also, as there are no data that in fact suggest the utility of alternative treatments for these lesions, the role of surgery is reinforced. Methods:A systematic search of English and non-English literature using MEDLINE on the outcomes of patients after surgical treatment of liver metastases from different solid tumours was undertaken. A summary of current surgical techniques used to improve their resectability has been added.Results: All papers reporting median survival and 5-year survival have been selected and presented in tables for most of the primary tumours reviewed. Conclusions:Apart from patients with colorectal and neuroendocrine tumours, liver resection may offer a significative survival advantage in selected patients, mainly those with metastases coming from breast, gastrointestinal stromal tumours, testis, ovary and kidney.

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Effect of subcentimeter nonpositive resection margin on hepatic recurrence in patients undergoing hepatectomy for colorectal liver metastases. Evidences from 663 liver resections

Abstract: Subcentimeter nonpositive resection margins do not directly influence hepatic recurrence in patients undergoing hepatectomy for colorectal liver metastases.

Cited by 115 publications

References 30 publications

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Prognostic factors and time-related changes influence results of colorectal liver metastases surgical treatment: A single-center analysis

Metastatic lesions to the liver: Surgical indications and techniques

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