Evidence map›Paper›PMID 42663774›Full record

ArticleAnnals of surgical oncology2026

Resection Margin Status, Recurrence Pattern, and Salvageability After Resection for Colorectal Liver Metastases.

Kizuki Yuza, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, George A Poultsides, Kazunari Sasaki, Itaru Endo, Federico Aucejo, Irinel Popescu, Tom Hugh, Nazim Bhimani and 3 more

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kizuki YuzaDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Odysseas P ChatzipanagiotouDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Andrea RuzzenenteDivision of General and Hepatobiliary Surgery, University of Verona, Verona, Italy.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA.
Kazunari SasakiDepartment of Surgery, Stanford University, Stanford, CA, USA.
Itaru EndoDepartment of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan.
Federico AucejoDepartment of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, OH, USA.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Tom HughDepartment of Surgery, School of Medicine Sydney, The University of Sydney, Sydney, Australia.
Nazim BhimaniDepartment of Surgery, School of Medicine Sydney, The University of Sydney, Sydney, Australia.
Matthew J WeissDepartment of Surgery, Cancer Institute, Northwell Health, New Hyde Park, NY, USA.
Jin HeDivision of Hepato-Pancreato-Biliary Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prognostic significance of margin status after colorectal liver metastases (CRLM) resection remains debated in the era of effective systemic therapy. This study examined the prognostic meaning of microscopically positive (R1) margins, focusing on recurrence pattern and salvageability.

methodsPatients undergoing curative-intent resection for CRLM were identified from an international multi-institutional database (2000-2023). Institution-stratified Cox models estimated associations between margin status and survival endpoints, with sequential adjustment for clinical factors, primary lymph node status, tumor burden, and neoadjuvant chemotherapy.

resultsAmong 1060 patients, 228 (21.5%) had R1 margins. Whereas R1 status was associated with higher crude hazards of recurrence or death, the adjusted association was weaker (complete-case hazard ratio [HR], 1.17; 95% confidence interval [CI], 0.89-1.54; multiply imputed HR, 1.34; 95% CI, 1.03-1.74). Among the patients who experienced recurrence, isolated liver recurrence was less common after R1 resection than after R0 resection (31.1% vs 47.6%; p = 0.004), whereas liver plus extrahepatic recurrence was numerically more common (26.2% vs 18.6%; p = 0.114). Repeat hepatectomy was less frequent after R1 resection (16.4% vs 31.4%; p < 0.001), particularly among node-negative patients (10.5% vs 39.7%; p < 0.001). Among the node-negative patients who experienced recurrence, post-recurrence survival was shorter after R1 resection (27.4 vs 43.8 months; p = 0.029).

conclusionsA microscopically positive resection margin was associated with worse crude outcomes. The adjusted association was weaker and varied according to how missing data were handled. Although R0 resection should remain the operative goal, R1 margin status may be better interpreted as a context-dependent prognostic marker, associated with recurrence less often confined to the liver and a lower likelihood of repeat hepatectomy, rather than as a purely technical endpoint.

Indexed as

Colorectal liver metastasesPost-recurrence survivalR1 resectionRecurrence patternRepeat hepatectomyResection marginSalvageability

Identifiers

PMID42663774

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