title: Intraoperative margin re-resection for colorectal liver metastases.
abstract: 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.
authors.affiliation: Department of Surgery and Radiology, Medical Center, University of Cincinnati College of Medicine, 234 Goodman Street NL 0772, Cincinnati, OH 45219, USA.
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Wray
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Lowy
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Matthews
authors.forename: Laura E
authors.initials: LE
authors.lastname: James
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Mammen
authors.forename: Kyuran A
authors.initials: KA
authors.lastname: Choe
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Hanto
authors.forename: Syed A
authors.initials: SA
authors.lastname: Ahmad
mesh_terms: 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