A positive resection margin does not determine long-term survival following colorectal liver metastasis resection

This study evaluates whether positive resection margins after colorectal liver metastasis (CRLM) surgery are linked to tumor recurrence and impact long-term survival.

The oncological outcomes of patients undergoing curative resection for CRLM at a single institution were analyzed concerning clinicopathological factors using both univariate and multivariate statistical methods.

Among 138 patients who underwent liver resection for CRLM, hepatic tumor recurrence was noted in 70 patients (50.7%), with no significant difference between those with R0 and R1 resections (p = 0.33). Positive resection margins were associated with tumor proximity to major liver vascular structures, while negative margins corresponded more frequently with T4 stage colorectal cancer. Multivariate analysis indicated that R1 margins in CRLM resections do not affect overall or disease-free survival. Nonetheless, the proximity of tumors to major liver vascular structures and R1 margins from initial colorectal cancer resections were significant independent predictors of poorer survival outcomes.

With the advent of modern perioperative systemic therapies, both hepatic recurrence and survival outcomes following hepatectomy for colorectal liver metastases seem unaffected by the presence of R1 resection margins.