Effect of Surgical Margin Status on Survival and Site of Recurrence After Hepatic Resection for Colorectal Metastases

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dc.contributor.author Pawlik, Timothy
dc.contributor.author Scoggins, Charles
dc.contributor.author Zorzi, Daria
dc.contributor.author Abdalla, Eddie
dc.contributor.author Andres, Axel
dc.contributor.author Eng, Cathy
dc.contributor.author Curley, Steven
dc.contributor.author Loyer, Evelyne
dc.contributor.author Muratore, Andrea
dc.contributor.author Mentha, Gilles
dc.contributor.author Capussotti, Lorenzo
dc.contributor.author Vauthey, Nicolas
dc.date.accessioned 2015-11-11T13:50:32Z
dc.date.available 2015-11-11T13:50:32Z
dc.date.copyright 2005
dc.date.issued 2015-11-11
dc.identifier.issn 0003-4932 en_US
dc.identifier.uri http://hdl.handle.net/10725/2537
dc.description.abstract Objective: To evaluate the influence of surgical margin status on survival and site of recurrence in patients treated with hepatic resection for colorectal metastases. Methods: Using a multicenter database, 557 patients who underwent hepatic resection for colorectal metastases were identified. Demographics, operative data, pathologic margin status, site of recurrence (margin, other intrahepatic site, extrahepatic), and long-term survival data were collected and analyzed. Results: On final pathologic analysis, margin status was positive in 45 patients, and negative by 1 to 4 mm in 129, 5 to 9 mm in 85, and ≥1 cm in 298. At a median follow-up of 29 months, the 1-, 3-, and 5-year actuarial survival rates were 97%, 74%, and 58%; median survival was 74 months. Tumor size ≥5 cm, >3 tumor nodules, and carcinoembryonic antigen level >200 ng/mL predicted poor survival (all P < 0.05). Median survival was 49 months in patients with positive margins and not yet reached in patients with negative margins (P = 0.01). After hepatic resection, 225 (40.4%) patients had recurrence: 21 at the surgical margin, 56 at another intrahepatic site, 82 at an extrahepatic site, and 66 at both intrahepatic and extrahepatic sites. Patients with negative margins of 1 to 4 mm, 5 to 9 mm, and ≥1 cm had similar overall recurrence rates (P > 0.05). Patients with positive margins were more likely to have surgical margin recurrence (P = 0.003). Adverse preoperative biologic factors including tumor number greater than 3 (P = 0.01) and a preoperative CEA level greater than 200 ng/mL (P = 0.04) were associated with an increased risk of positive surgical margin. Conclusions: A positive margin after resection of hepatic colorectal metastases is associated with adverse biologic factors and increased risk of surgical-margin recurrence. The width of a negative surgical margin does not affect survival, recurrence risk, or site of recurrence. A predicted margin of <1 cm after resection of hepatic colorectal metastases should not be used as an exclusion criterion for resection. en_US
dc.language.iso en en_US
dc.title Effect of Surgical Margin Status on Survival and Site of Recurrence After Hepatic Resection for Colorectal Metastases en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Annals of surgery en_US
dc.journal.volume 24 en_US
dc.journal.issue 5 en_US
dc.article.pages 715-724 en_US
dc.identifier.doi http://dx.doi.org/ 10.1097/01.sla.0000160703.75808.7d en_US
dc.identifier.ctation Pawlik, T. M., Scoggins, C. R., Zorzi, D., Abdalla, E. K., Andres, A., Eng, C., ... & Vauthey, J. N. (2005). Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Annals of Surgery, 241(5), 715. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://journals.lww.com/annalsofsurgery/Abstract/2005/05000/Effect_of_Surgical_Margin_Status_on_Survival_and.5.aspx

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