Prognostic influence of hepatic margin after resection of colorectal liver metastasis: role of modern preoperative chemotherapy

International Journal of Colorectal Disease
Frank MakowiecHannes P Neeff

Abstract

Modern chemotherapy (CTX) increases survival in stage IV colorectal cancer. In colorectal liver metastases (CLM), neoadjuvant (neo) CTX may increase resectability and improve survival. Due to widespread use of CTX in CLM, recent studies assessed the role of the hepatic margin after CTX, with conflicting results. We evaluated the outcome after resection of CLM in relation to CTX and hepatic resection status. Since 2000, 334 patients with first hepatic resection for isolated CLM were analyzed. Thirty-two percent had neoadjuvant chemotherapy (targeted therapy in 42%). Sixty-eight percent never had CTX before hepatectomy or longer than 6 months before resection. The results were gained by analysis of our prospective database. Positive hepatic margins occurred in 8% (independent of neoCTx). Patients after neoCTX had higher numbers of CLM (p < 0.01) and a longer duration of surgery (p < 0.03). After hepatectomy, 5-year survival was 45% and correlated strongly with the margin status (47% in R-0 and 21% in R-1; p < 0.001). Survival also correlated with margin status in the subgroups with neoCTX (p < 0.01) or without neoCTx (p < 0.01). In multivariate analysis of the entire group, hepatic margin status (RR 3.2; p < 0.001) and age > 65 y...Continue Reading

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Citations

Nov 14, 2018·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·Ulf KulikHarald Schrem
Jun 5, 2018·Annals of Gastroenterological Surgery·Eiji OkiYoshihiko Maehara
Aug 28, 2020·Insights Into Imaging·Luisa PaulattoMaxime Ronot
Dec 5, 2018·World Journal of Clinical Cases·Feng XuChao-Liu Dai
Jul 31, 2019·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·R VeraG Suarez-Artacho
Oct 24, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Claudya MorinJean-Francois B Ouellet
May 24, 2021·Langenbeck's Archives of Surgery·Wong Hoi SheChung Mau Lo

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