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Related Experiment Video

Updated: Oct 14, 2025

The Influence of Liver Resection on Intrahepatic Tumor Growth
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Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for

Yujiro Nishioka1, Natalia Paez-Arango1, Federico Oppliger Boettcher1

  • 1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|November 2, 2021
PubMed
Summary

Surgical margin width and somatic mutations did not impact local recurrence (LR) after colorectal liver metastases (CLM) resection. Tumor biology, not surgical margins, likely drives LR and prognosis in CLM patients.

Keywords:
Colorectal liver metastasesHepatectomyLocal recurrenceSomatic mutationSurgical margin

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Genomics

Background:

  • Colorectal liver metastases (CLM) pose a significant challenge in cancer treatment.
  • R0-intent resection aims for microscopically negative margins to improve outcomes.
  • Understanding factors influencing local recurrence (LR) and survival is crucial.

Purpose of the Study:

  • To evaluate the association between surgical margin status and somatic mutations with LR and oncologic outcomes in CLM patients undergoing R0-intent resection.
  • To identify predictors of local recurrence and their impact on survival.

Main Methods:

  • Analysis of 552 patients with CLM who underwent R0-intent resection and next-generation sequencing (2001-2018).
  • Classification of recurrences into local (LR), intrahepatic, and extrahepatic.
  • Univariate and multivariate analyses to assess predictors of LR and survival.

Main Results:

  • 75% of patients achieved R0 resection (margin width ≥ 1.0 mm); 7% experienced LR.
  • LR incidence was not significantly affected by surgical margin width.
  • RAS/TP53 co-mutation was linked to increased intrahepatic and overall recurrence, but not LR.
  • Extrahepatic disease, >8 cycles of preoperative chemotherapy, tumor viability ≥ 50%, RAS/TP53, and SMAD4 mutations were independently associated with poor overall survival.

Conclusions:

  • Surgical margin width and somatic mutations did not influence LR risk after R0-intent hepatectomy for CLM.
  • Individual tumor biology, rather than surgical margins, appears to be the primary driver of LR and prognosis in CLM.