Size of surgical margin does not influence recurrence rates after curative liver resection for colorectal cancer liver metastases
Size of surgical margin does not influence recurrence rates after curative liver resection for colorectal cancer liver metastases
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DOI：
10.1002/bjs.5762
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发表时间：
2007-09-01
影响因子：
9.6
通讯作者：
Gruenberger, T.
中科院分区：
文献类型：
--
作者：
Bodingbauer, M.;Tamandl, D.;Gruenberger, T.
背景：本研究的目的是探讨使用超声解剖技术对结直肠转移瘤进行潜在根治性肝切除术后切缘状态与复发部位之间的关系。方法：2000 年 1 月至 2003 年 12 月期间，176 名患者在同一机构接受了结直肠转移瘤的根治性肝切除术。前瞻性收集并分析人口统计学、手术数据、病理切缘状态、复发部位和长期生存数据。结果：病理分析中，切除切缘阳性43例，1-9毫米阴性110例，清除9毫米以上23例。中位随访时间为 33 个月，176 名患者中有 133 名出现复发，其中只有 5 名患者在手术切缘处复发。手术切缘的复发与切缘的大小没有显着相关。总体而言，中位复发时间为 12.6 个月，与手术切缘大小无关，尽管切缘阳性组中多发转移患者的比例显着较高（P = 0.008）。切缘状态与无复发或总生存率没有显着相关性。结论：手术切缘复发率较低，切缘阳性与手术切缘或其他部位复发风险增加无关。
Background: The aim of this study was to examine the relationship between surgical margin status and site of recurrence after potentially curative liver resection for colorectal metastases using an ultrasonic dissection technique.Methods: Between January 2000 and December 2003, 176 patients underwent liver resection with curative intent for colorectal metastases at a single institution. Demographics, operative data, pathological margin status, site of recurrence and long-term survival data were collected prospectively and analysed.Results: On pathological analysis, resection margins were positive in 43 patients, negative by 1-9 mm in 110, and clear by more than 9 mm in 23 patients. At a median follow-up of 33 months, 133 of 176 patients had developed a recurrence, only five of whom had recurrence at the surgical margin. Recurrence at the surgical margin was not significantly related to the size of the margin. Overall, the median time to recurrence was 12.6 months, which was independent of surgical margin size, although there was a significantly higher proportion of patients with multiple metastases in the group with a positive margin (P = 0.008). Margin status did not correlate significantly with either recurrence-free or overall survival.Conclusion: The rate of recurrence at the surgical margin was low and a positive margin was not associated with an increased risk of recurrence either at the surgical margin or elsewhere.