Impact of Surgical Margin Width on Recurrence and Overall Survival Following R0 Hepatic Resection of Colorectal Metastases: A Systematic Review and Meta-analysis

OBJECTIVE:To examine the impact of surgical margin width on survival following R0 hepatic resection for colorectal metastases (CRLM). SUMMARY OF BACKGROUND DATA:Although negative resection margin is considered of paramount importance for the prognosis of patients with colorectal liver metastases, op...

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Veröffentlicht in:Annals of surgery 2018-06, Vol.267 (6), p.1047-1055
Hauptverfasser: Margonis, Georgios A, Sergentanis, Theodoros N, Ntanasis-Stathopoulos, Ioannis, Andreatos, Nikolaos, Tzanninis, Ioannis-Georgios, Sasaki, Kazunari, Psaltopoulou, Theodora, Wang, Jaeyun, Buettner, Stefan, Papalois, Αpostolos E, He, Jin, Wolfgang, Christopher L, Pawlik, Timothy M, Weiss, Matthew J
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Sprache:eng
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Zusammenfassung:OBJECTIVE:To examine the impact of surgical margin width on survival following R0 hepatic resection for colorectal metastases (CRLM). SUMMARY OF BACKGROUND DATA:Although negative resection margin is considered of paramount importance for the prognosis of patients with colorectal liver metastases, optimal resection margin width remains controversial. METHODS:Eligible studies examining the association between margin status after R0 hepatic resection for CRLM and survival, including overall survival (OS) and disease-free survival (DFS) were sought using the Medline, Cochrane, and EMBASE databases. Random-effects models were used for the calculation of pooled relative risks (RRs) with their 95% confidence intervals (95% CIs). RESULTS:Thirty-four studies were deemed eligible for inclusion representing a cohort of 11,147 hepatic resections. Wider resection margin (>1 vs 1 cm resection margin at 3, 5, and 10 years. Interestingly, >1 mm (vs 1 mm margin is associated with better prognosis than a submillimeter margin, achieving a margin >1 cm may result in even better oncologic outcomes and should be considered if possible.
ISSN:0003-4932
1528-1140
DOI:10.1097/SLA.0000000000002552