Resection margin in patients undergoing hepatectomy for colorectal liver metastasis: a critical appraisal of the 1cm rule
Resection margin in patients undergoing hepatectomy for colorectal liver metastasis: a critical appraisal of the 1cm rule
AIM: We undertook this study to evaluate the influence of resection margin distance from metastases on survival and post-operative disease recurrence after hepatectomy for colorectal liver metastasis.
METHODS: Between January 1993 and December 2001, 293 consecutive patients underwent primary liver resection for colorectal metastasis. Clinical, pathological and outcome data were analysed using a prospectively collected database. Cases were stratified into those with involved and non-involved resection margins. Different non-involved margin widths were analysed against survival, recurrence rate and pattern (hepatic, extra hepatic) of recurrence.
RESULTS: The 1, 3, 5 and 10 years actuarial survival rates were 82, 58, 44 and 36%, respectively. The median survival was 46 months. The histological liver resection margin involvement was a significant predictor of survival and disease free survival after surgery. One, two, five and 10 millimetres disease free resection margin widths were found not to be significant in influencing patients' survival or recurrence rate.
CONCLUSION: A positive hepatic resection margin was associated with a higher incidence of post-operative recurrence and lower survival rate. The width of the resection margin did not influence the post-operative recurrence rate or pattern of recurrence. The '1 cm rule' should be abandoned.
Actuarial Analysis, Adult, Aged, Aged, 80 and over, Colonic Neoplasms/pathology, Disease-Free Survival, Female, Follow-Up Studies, Forecasting, Hepatectomy/methods, Humans, Liver/pathology, Liver Neoplasms/pathology, Longitudinal Studies, Male, Microsurgery/methods, Middle Aged, Neoplasm Recurrence, Local/pathology, Prospective Studies, Rectal Neoplasms/pathology, Retrospective Studies, Survival Rate, Treatment Outcome
557-63
Hamady, Z Z R
545a1c81-276e-4341-a420-aa10aa5d8ca8
Cameron, I C
f7595539-efa6-4687-b161-e1e93ff710f2
Wyatt, J
8361be5a-fca9-4acf-b3d2-7ce04126f468
Prasad, R K
674781c5-b624-46db-bd4e-3c5b9ba44064
Toogood, G J
f2183798-4d71-42fd-bcc9-483f191c066f
Lodge, J P A
c97dd104-0cb2-4f05-a008-9b9af01e4820
June 2006
Hamady, Z Z R
545a1c81-276e-4341-a420-aa10aa5d8ca8
Cameron, I C
f7595539-efa6-4687-b161-e1e93ff710f2
Wyatt, J
8361be5a-fca9-4acf-b3d2-7ce04126f468
Prasad, R K
674781c5-b624-46db-bd4e-3c5b9ba44064
Toogood, G J
f2183798-4d71-42fd-bcc9-483f191c066f
Lodge, J P A
c97dd104-0cb2-4f05-a008-9b9af01e4820
Hamady, Z Z R, Cameron, I C, Wyatt, J, Prasad, R K, Toogood, G J and Lodge, J P A
(2006)
Resection margin in patients undergoing hepatectomy for colorectal liver metastasis: a critical appraisal of the 1cm rule.
European Journal of Surgical Oncology, 32 (5), .
(doi:10.1016/j.ejso.2006.02.001).
Abstract
AIM: We undertook this study to evaluate the influence of resection margin distance from metastases on survival and post-operative disease recurrence after hepatectomy for colorectal liver metastasis.
METHODS: Between January 1993 and December 2001, 293 consecutive patients underwent primary liver resection for colorectal metastasis. Clinical, pathological and outcome data were analysed using a prospectively collected database. Cases were stratified into those with involved and non-involved resection margins. Different non-involved margin widths were analysed against survival, recurrence rate and pattern (hepatic, extra hepatic) of recurrence.
RESULTS: The 1, 3, 5 and 10 years actuarial survival rates were 82, 58, 44 and 36%, respectively. The median survival was 46 months. The histological liver resection margin involvement was a significant predictor of survival and disease free survival after surgery. One, two, five and 10 millimetres disease free resection margin widths were found not to be significant in influencing patients' survival or recurrence rate.
CONCLUSION: A positive hepatic resection margin was associated with a higher incidence of post-operative recurrence and lower survival rate. The width of the resection margin did not influence the post-operative recurrence rate or pattern of recurrence. The '1 cm rule' should be abandoned.
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More information
Published date: June 2006
Keywords:
Actuarial Analysis, Adult, Aged, Aged, 80 and over, Colonic Neoplasms/pathology, Disease-Free Survival, Female, Follow-Up Studies, Forecasting, Hepatectomy/methods, Humans, Liver/pathology, Liver Neoplasms/pathology, Longitudinal Studies, Male, Microsurgery/methods, Middle Aged, Neoplasm Recurrence, Local/pathology, Prospective Studies, Rectal Neoplasms/pathology, Retrospective Studies, Survival Rate, Treatment Outcome
Identifiers
Local EPrints ID: 455115
URI: http://eprints.soton.ac.uk/id/eprint/455115
ISSN: 0748-7983
PURE UUID: ac2b0caa-852b-472e-b04f-c2d5242b9acd
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Date deposited: 10 Mar 2022 17:30
Last modified: 17 Mar 2024 04:12
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Author:
Z Z R Hamady
Author:
J Wyatt
Author:
R K Prasad
Author:
G J Toogood
Author:
J P A Lodge
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