ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018
R1 Resection for Colorectal Liver Metastases: a Survey Questioning Surgeons about Its Incidence, Clinical Impact, and Management.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Oncological Adequacy of R1 Vascular Margin in Minimally Invasive Liver Surgery for Hepatocellular Carcinoma and Colorectal Liver Metastases: A Meta-analysis.Annals of surgical oncology · 2026Pooled it
- Testing the Use of Indocyanine Green Fluorescence Image-Guidance in Patients with Liver Surgery Compared To Patients with Standard Liver Surgery: A Feasibility Randomised Controlled Trial.Journal of fluorescence · 2026Trial
- Resection Margin Status, Recurrence Pattern, and Salvageability After Resection for Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
- The Clinical Utility of Three-Dimensional Liver Modelling: A Multicenter Survey.Journal of imaging informatics in medicine · 2026Article
- How to Integrate Surgery into the Multidisciplinary Treatment of Liver-Only Metastatic Colorectal Cancer.Cancers · 2026Review
- Risk factors, prognostic factors, and nomograms for liver metastasis in stage TScientific reports · 2025Article
- Mid-transversal hepatectomy: breaking new ground in parenchymal sparing hepatectomies.Updates in surgery · 2025Article
- Ranking as a Procedure for Selecting a Replacement Variable in the Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases.Medicina (Kaunas, Lithuania) · 2023Article
- Association between textbook outcome and long-term survival after surgery for colorectal liver metastases.The British journal of surgery · 2023Article
- Implementation and Outcome of Robotic Liver Surgery in the Netherlands: A Nationwide Analysis.Annals of surgery · 2023Article
- Article
- Colorectal Cancer Liver Metastases: Is an R1 Hepatic Resection Accepted?Clinics and practice · 2022Review
- Survival by Number and Sites of Resections of Recurrence after First Curative Resection of Colorectal Liver Metastases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 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
- Laparoscopic Resection of Synchronous Liver Metastasis Involving the Left Hepatic Vein and the Common Trunk Bifurcation: A Strategy of Parenchyma-Sparing Resection with Left Sectionectomy and 4a Subsegmentectomy by Arantius Approach.Healthcare (Basel, Switzerland) · 2022Article
- Very Early Recurrence After Liver Resection for Colorectal Metastases: Incidence, Risk Factors, and Prognostic Impact.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Technique of vessel-skeletonized parenchyma-sparing hepatectomy for the oncological treatment of bilobar colorectal liver metastases.Langenbeck's archives of surgery · 2022Article
- Solitary colorectal liver metastasis: overview of treatment strategies and role of prognostic factors.Journal of cancer research and clinical oncology · 2022Review
- Review
- Analysis of survival factors after hepatic resection for colorectal cancer liver metastases: Does the R1 margin matter?Frontiers in surgery · 2022Article
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Authors and funding
11 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA ≥ 1-mm margin is standard for resection of colorectal liver metastases (CLM). However, R1 resection is not rare (10-30%), and chemotherapy could mitigate its impact. The possibility of detaching CLM from vessels (R1 vascular margin) has been described. A reappraisal of R1 resection is needed.
methodsA 19-question survey regarding R1 resection for CLM was sent to hepatobiliary surgeons worldwide. Seven clinical cases were included.
resultsIn total, 276 surgeons from 52 countries completed the survey. Ninety percent reported a negative impact of R1 resection (74% local recurrence, 31% hepatic recurrence, and 36% survival), but 50% considered it sometimes required for resectability. Ninety-one percent of responders suggested that the impact of R1 resection is modulated by the response to chemotherapy and/or CLM characteristics. Half considered the risk of R1 resection to be an indication for preoperative chemotherapy in patients who otherwise underwent upfront resection, and 40% modified the chemotherapy regimen when the tumor response did not guarantee R0 resection. Nevertheless, 80% scheduled R1 resection for multiple bilobar CLM that responded to chemotherapy. Forty-five percent considered the vascular margin equivalent to R0 resection. However, for lesions in contact with the right hepatic vein, right hepatectomy remained the standard. Detachment from the vein was rarely considered (10%), but 27% considered detachment in the presence of multiple bilobar CLM.
conclusionsA negative margin is still standard for CLM, but R1 resection is no longer just a technical error. R1 resection should be part of the modern multidisciplinary, aggressive approach to CLM.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.