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 |
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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. |
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ISSN: | 0003-4932 1528-1140 |
DOI: | 10.1097/SLA.0000000000002552 |