The Margin of the Largest Tumor Predicts Overall Survival After Resection of Multitumor Colorectal Liver Metastases

Fong Y, Fortner J, Sun RL, et al. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–18.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Gomez D, Morris-Stiff G, Toogood GJ, et al. Interaction of tumour biology and tumour burden in determining outcome after hepatic resection for colorectal metastases. HPB (Oxford). 2010;12(2):84–93.

Article  PubMed  PubMed Central  Google Scholar 

Hatta AAZ, Pathanki AM, Hodson J, et al. The effects of resection margin and KRAS status on outcomes after resection of colorectal liver metastases. HPB (Oxford). 2021;23(1):90–8.

Article  PubMed  Google Scholar 

Jayme VR, Fonseca GM, Amaral IMA, et al. Infiltrative tumor borders in colorectal liver metastasis: should we enlarge margin size? Ann Surg Oncol. 2021;28(12):7636–46.

Article  PubMed  Google Scholar 

Mao R, Zhao JJ, Bi XY, et al. Interaction of margin status and tumour burden determines survival after resection of colorectal liver metastases: a retrospective cohort study. Int J Surg. 2018;53:371–7.

Article  PubMed  Google Scholar 

Pikoulis E, Papaconstantinou D, Pikouli A, et al. Is precision surgery applicable to colorectal liver metastases? A systematic review and meta-analysis of studies that investigate the association of surgical technique with outcomes in the context of distinct tumor biology. Ann Surg Oncol. 2024;31(3):1823–32.

Article  PubMed  Google Scholar 

Truant S, Sequier C, Leteurtre E, et al. Tumour biology of colorectal liver metastasis is a more important factor in survival than surgical margin clearance in the era of modern chemotherapy regimens. HPB (Oxford). 2015;17(2):176–84.

Article  PubMed  Google Scholar 

Sadot E, Groot Koerkamp B, Leal JN, et al. Resection margin and survival in 2368 patients undergoing hepatic resection for metastatic colorectal cancer: surgical technique or biologic surrogate? Ann Surg. 2015;262(3):476–85.

Article  PubMed  PubMed Central  Google Scholar 

Perrin T, McIntyre SM, Ehrich F, et al. The association between surgical margin status, recurrence patterns, and oncologic outcomes in patients with colorectal liver metastases. Ann Surg. 2025.

McIntyre SM, Soares KC, Chou JF, et al. Surgical margin of resected colorectal liver metastases: how accurate is surgeon prediction? Ann Surg. 2024;280(2):311–6.

Article  PubMed  Google Scholar 

Wakai T, Shirai Y, Sakata J, et al. Histologic evaluation of intrahepatic micrometastases in patients treated with or without neoadjuvant chemotherapy for colorectal carcinoma liver metastasis. Int J Clin Exp Pathol. 2012;5(4):308–14.

CAS  PubMed  PubMed Central  Google Scholar 

Zhang Q, Peng J, Ye M, et al. KRAS mutation predicted more mirometastases and closer resection margins in patients with colorectal cancer liver metastases. Ann Surg Oncol. 2020;27(4):1164–73.

Article  PubMed  Google Scholar 

Iwaki K, Kaihara S, Koyama T, et al. The impact of KRAS status on the required surgical margin width for colorectal liver metastasis resection. J Clin Med. 2023;12(6):2313.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Sasaki K, Margonis GA, Maitani K, et al. The prognostic impact of determining resection margin status for multiple colorectal metastases according to the margin of the largest lesion. Ann Surg Oncol. 2017;24(9):2438–46.

Article  PubMed  Google Scholar 

Lemon SC, Roy J, Clark MA, et al. Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med. 2003;26(3):172–81.

Article  PubMed  Google Scholar 

Muller R, Mockel M. Logistic regression and CART in the analysis of multimarker studies. Clin Chim Acta. 2008;394(1–2):1–6.

Article  CAS  PubMed  Google Scholar 

Nunn ME, Fan J, Su X, et al. Development of prognostic indicators using classification and regression trees for survival. Periodontol 2000. 2012;58(1):134–42.

Article  PubMed  PubMed Central  Google Scholar 

Are C, Gonen M, Zazzali K, et al. The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann Surg. 2007;246(2):295–300.

Article  PubMed  PubMed Central  Google Scholar 

Brudvik KW, Mise Y, Chung MH, et al. RAS mutation predicts positive resection margins and narrower resection margins in patients undergoing resection of colorectal liver metastases. Ann Surg Oncol. 2016;23(8):2635–43.

Article  PubMed  PubMed Central  Google Scholar 

Ren W, Sell NM, Ferrone CR, et al. Size of the largest colorectal liver metastasis is an independent prognostic factor in the neoadjuvant setting. J Surg Res. 2021;259:253–60.

Article  PubMed  Google Scholar 

Tsilimigras DI, Hyer JM, Bagante F, et al. Resection of colorectal liver metastasis: prognostic impact of tumor burden vs KRAS mutational status. J Am Coll Surg. 2021;232(4):590–8.

Article  PubMed  Google Scholar 

Kamphues C, Andreatos N, Kruppa J, et al. The optimal cut-off values for tumor size, number of lesions, and CEA levels in patients with surgically treated colorectal cancer liver metastases: an international, multi-institutional study. J Surg Oncol. 2021;123(4):939–48.

Article  CAS  PubMed  Google Scholar 

Pawlik TM, Scoggins CR, Zorzi D, et al. Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg. 2005;241(5):715–24.

Article  PubMed  PubMed Central  Google Scholar 

Benedetti Cacciaguerra A, Gorgec B, Cipriani F, et al. Risk factors of positive resection margin in laparoscopic and open liver surgery for colorectal liver metastases: a new perspective in the perioperative assessment: a European multicenter study. Ann Surg. 2022;275(1):e213–21.

Article  PubMed  Google Scholar 

Margonis GA, Sergentanis TN, Ntanasis-Stathopoulos I, et al. Impact of surgical margin width on recurrence and overall survival following R0 hepatic resection of colorectal metastases: a systematic review and meta-analysis. Ann Surg. 2018;267(6):1047–55.

Article  PubMed  Google Scholar 

Sasaki K, Margonis GA, Andreatos N, et al. Prognostic impact of margin status in liver resections for colorectal metastases after bevacizumab. Br J Surg. 2017;104(7):926–35.

Article  CAS  PubMed  Google Scholar 

Di Carlo S, Yeung D, Mills J, et al. Resection margin influences the outcome of patients with bilobar colorectal liver metastases. World J Hepatol. 2016;8(34):1502–10.

Article  PubMed  PubMed Central  Google Scholar 

Ai XN, Tao M, Wang HY, et al. Analysis of survival factors after hepatic resection for colorectal cancer liver metastases: does the R1 margin matter? Front Surg. 2022;9:1020240.

Article  PubMed  Google Scholar 

Liu W, Sun Y, Zhang L, et al. Negative surgical margin improved long-term survival of colorectal cancer liver metastases after hepatic resection: a systematic review and meta-analysis. Int J Colorectal Dis. 2015;30(10):1365–73.

Article  PubMed  Google Scholar 

Nuzzo G, Giuliante F, Ardito F, et al. Influence of surgical margin on type of recurrence after liver resection for colorectal metastases: a single-center experience. Surgery. 2008;143(3):384–93.

Article  PubMed  Google Scholar 

Lee KS, Suchett-Kaye I, Abbadi R, et al. Microscopic resection margins adversely influence survival rates after surgery for colorectal liver metastases: an open ambidirectional cohort study. Int J Surg. 2020;83:8–14.

Article  PubMed  Google Scholar 

Xu D, Wang HW, Yan XL, et al. Sub-millimeter surgical margin is acceptable in patients with good tumor biology after liver resection for colorectal liver metastases. Eur J Surg Oncol. 2019;45(9):1551–8.

Article  PubMed  Google Scholar 

Sakamoto K, Beppu T, Ogawa K, et al. Prognostic Impact of Surgical Margin Width in Hepatectomy for colorectal liver metastasis. J Clin Transl Hepatol. 2023;11(3):705–17.

PubMed  PubMed Central  Google Scholar 

Comments (0)

No login
gif