Reduction in recurrence risk for involved or inadequate margins with edge cryotherapy after liver resection for colorectal metastases.
OBJECTIVE
The usefulness of additional edge cryotherapy after liver resection for liver metastases from colorectal cancer to improve involved or inadequate (less than 1 cm) margins is uncertain.


METHODS
Retrospective analysis of prospectively collected data.


METHODS
Department of surgery at a university hospital.


METHODS
Eighty-six consecutive patients with hepatic metastases from colorectal cancer in whom we applied additional edge cryotherapy to involved or inadequate margins. This group was compared with 134 patients who underwent resection without edge cryotherapy (control group) during the same period.


METHODS
Potentially curative treatment was achieved by adding edge cryotherapy to insufficient resection sites in patients not eligible for further resection.


METHODS
Edge recurrence rate in the study group; validation of an additional treatment to improve curative resectability; and comparison of morbidity and local recurrence rates with the control group.


RESULTS
At a median follow-up of 39 months, 47 patients were alive and 39 had died. Local recurrence at the resection site was diagnosed in 9 patients (10%), of which 7 occurred in patients with involved margins and 2 in patients with resection margin less than 1 cm. Thirty-six patients (42%) experienced recurrence in the remnant liver. Extrahepatic recurrence occurred in 38 patients (44%), the lungs being the most common site (22 patients [26%]).


CONCLUSIONS
Edge cryotherapy is a potent additional surgical treatment option in patients with liver metastases from colorectal cancer. The percentage of patients who can be treated for cure can be increased, especially if complex liver surgery is demanded.
Gruenberger
T
T
Department of Surgery, UNSW, St George Hospital, Pitney Clinical Science Bldg, Level 3, Kogarah, Sydney, New South Wales 2217, Australia. David.Morris@unsw.edu.au
Jourdan
J L
JL
Zhao
J
J
King
J
J
Morris
D L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D003452:Cryosurgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate