Intraoperative margin re-resection for colorectal liver metastases.
OBJECTIVE
Evaluate recurrence and survival in patients who underwent intraoperative margin re-resection for colorectal cancer liver (CRC) metastases.


METHODS
Retrospective analysis.


METHODS
University Hospital, Cincinnati, Ohio. Academic medical center.


METHODS
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.


CONCLUSIONS
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.
Wray
Curtis J
CJ
Department of Surgery and Radiology, Medical Center, University of Cincinnati College of Medicine, 234 Goodman Street NL 0772, Cincinnati, OH 45219, USA.
Lowy
Andrew M
AM
Matthews
Jeffrey B
JB
James
Laura E
LE
Mammen
Joshua M
JM
Choe
Kyuran A
KA
Hanto
Douglas W
DW
Ahmad
Syed A
SA
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016019:Survival Analysis