ReviewHPB : the official journal of the International Hepato Pancreato Biliary Association2015
Tumour biology of colorectal liver metastasis is a more important factor in survival than surgical margin clearance in the era of modern chemotherapy regimens.
Review in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Is Precision Surgery Applicable to Colorectal Liver Metastases? A Systematic Review and Meta-analysis of Studies that Investigate the Association of Surgical Technique with Outcomes in the Context of Distinct Tumor Biology.Annals of surgical oncology · 2024Pooled it
- Adjuvant chemotherapy for resected colorectal cancer metastases: Literature review and meta-analysis.World journal of gastroenterology · 2016Pooled it
- Negative surgical margin improved long-term survival of colorectal cancer liver metastases after hepatic resection: a systematic review and meta-analysis.International journal of colorectal disease · 2015Pooled it
- Resection Margin Status, Recurrence Pattern, and Salvageability After Resection for Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
- Review
- The Margin of the Largest Tumor Predicts Overall Survival After Resection of Multitumor Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
- Margins in Context: How Pathologic Response Reframes Surgical Success in CRLM.Annals of surgical oncology · 2026Article
- Article
- Prognostic effect of surgical margin in patients undergoing hepatectomy for colorectal liver metastasis.Hepatobiliary surgery and nutrition · 2025Article
- Article
- Review
- Prognostic Impact of Surgical Margin Width in Hepatectomy for Colorectal Liver Metastasis.Journal of clinical and translational hepatology · 2023Review
- Prognostic impact of R1 resection margin in synchronous and simultaneous colorectal liver metastasis resection: a retrospective cohort study.World journal of surgical oncology · 2023Article
- Precision Surgery of Colorectal Liver Metastases in the Current Era: A Systematic Review.Cancers · 2023Review
- The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection.Journal of clinical medicine · 2023Article
- Multimodal Management of Colorectal Liver Metastases: State of the Art.Oncology reviews · 2023Review
- Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Article
- Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for Colorectal Liver Metastases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Article
- Analysis of survival factors after hepatic resection for colorectal cancer liver metastases: Does the R1 margin matter?Frontiers in surgery · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of the authors was to reassess the impact of a positive surgical margin (R1) after a liver resection for colorectal liver metastases (CLMs) on survival in the era of modern chemotherapy, through their own experience and a literature review.
methodsInclusion criteria were: R1 or R0 resection with no local treatment modalities, extra-hepatic metastases or other cancer.
resultsAmong 337 patients operated between 2000 and 2010, 273 patients were eligible (214 R0/59 R1). The mean follow-up was 43 ± 29 months. Compared with a R0 resection, a R1 resection offered a lower 5-year overall (39.1% versus 54.2%, P = 0.010), disease-free (15.2% versus 31.1%, P = 0.021) and progression-free (i.e. time to the first non-curable recurrence; 33.1% versus 47.3%, P = 0.033) survival rates. Metastases in the R1 group were more numerous, larger and more frequently synchronous. Independent factors of poor survival were: number, size and short-time interval of CLM occurrence, N status, rectal primary, absence of adjuvant chemotherapy, but not a R1 resection. With the more-systematic administration of chemotherapy since 2005, the intergroup difference in progression-free survival disappeared (P = 0.264).
conclusionA R1 resection had no prognostic value per se but reflected a more severe disease. The recent change in the prognostic value of a R1 resection may be linked to the beneficial effect of chemotherapy.
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