Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 10.
doi: 10.1097/SLA.0000000000006659. Online ahead of print.

The Association Between Surgical Margin Status, Recurrence Patterns, and Oncologic Outcomes in Patients with Colorectal Liver Metastases

Thomas Perrin  1   2 , Sarah M McIntyre  1 , Fiona Ehrich  3 , Jon Heiselman  1 , Eric P van der Stok  1   4 , Megan Fiasconaro  3 , Mithat Gönen  3 , Jinru Shia  5 , T Peter Kingham  1 , Vinod P Balachandran  1 , Jeffrey A Drebin  1 , Alice C Wei  1 , William R Jarnagin  1 , Michael I D'Angelica  1
Affiliations

The Association Between Surgical Margin Status, Recurrence Patterns, and Oncologic Outcomes in Patients with Colorectal Liver Metastases

Thomas Perrin et al. Ann Surg. .

Abstract

Objective: To enhance understanding of the relationships between margin width, recurrence patterns, recurrence-free survival, and salvage therapy following initial hepatectomy for colorectal liver metastases (CRLM).

Background: The prognostic implications of the technical aspects of CRLM have not been well-characterized.

Methods: A prospective database of 1776 patients who underwent complete resection for CRLM at a single institution (1991-2012) was studied. Pathologic margins were divided into positive, <1 mm, 1.0-9.9 mm, and ≥10 mm groups. Recurrence-free survival, patterns of initial and overall recurrence, including recurrence at the resection margin, and chance for salvage therapy, defined as complete eradication of recurrent disease, were compared by margin group.

Results: Margin status was independently associated with an initial isolated liver recurrence (hazard ratio [HR][95% CI] for positive, <1 mm, 1-9.9 mm vs.≥10 mm margin: 2.21[1.49-3.26],1.42[0.84-2.40],1.41[1.08-1.84];P=0.001). Margin status was also independently associated with risk of initial recurrence at the resection margin (HR[95% CI] for positive, <1 mm, 1-9.9 mm vs.≥10 mm margin: 2.11[1.26-3.54],2.99[1.74-5.15],0.92[0.62-1.37];P<0.001) and risk of liver recurrence at any time (HR[95% CI] for positive, <1 mm, 1-9.9 mm vs.≥10 mm margin: 2.32[1.79-3.01],1.72[1.23-2.42],1.33[1.11-1.58];P<0.001). Estimated 3-year cumulative incidence of overall recurrence at any site in the positive, <1 mm, 1-9.9 mm, and ≥10 mm margin groups was 70%, 70%, 57% , and 50%, respectively. Salvage therapy after recurrence increased with margin width(P<0.001).

Conclusion: Pathologic margin after resection of CRLM is associated with higher rates of overall recurrence that are less amenable to salvage and not just local failure. Margin status may be more of a reflection of underlying tumor characteristics rather than simply a risk factor for local failure.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest and Source of Funding: The preparation of this study was funded in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center. Eighth author Dr. Jinru Shia reports consulting and professional activities for Paige AI. Tenth author Dr. Vinod P. Balachandran reports professional services and activities for Genentech. Eleventh author Dr. Jeffrey A. Drebin reports equity in Alnylam, Arrowhead Pharmaceuticals, Inc, and Ionis Pharmaceuticals, Inc. All other authors have no conflict of interest disclosures to report, and the findings presented in this manuscript have not been published elsewhere.

LinkOut - more resources