Title: Surgical Outcomes after Microscopic Incomplete Resection (R1) of Colorectal Liver Metastases in the Era of Aggressive Surgical Approach

Abstract:

A ≥ 1-mm margin is standard for resection of colorectal liver metastases (CRLM). However, microscopic incomplete resection (R1) is not rate because aggressive surgical resection has been attempted in multiple and bilobar CLM. In this study, we analyzed surgical outcomes after R1 resection of CRLM.From 2005 to 2018, 371 consecutive patients undergoing liver resection for CRLM were included. R1 resection was defined to have  All patients were divided into R0  and R1 group. Recurrence pattern disease-free survival(DFS) and overall survival(OS) were analyzed between the two groups.A total of 371 patients included in the study,3 patients were Excluded as ther were R2 liver resection. Among them, R1 resection was found in 42 (11.3%) patients. The median age at diagnosis was 59 years (range, 22 to 86). There were 246 (33.7%) men and 125 women (66.3%). The incidence of intrahepatic recurrence was not significantly different between R0 and R1 resection. Similarly, there was no significant difference in term of surgical margin recurrences between patients with R0 and R1 resections (42% [35/84] vs 35% [6/17], respectively, P = 0.788). When comparing R0 and R1 resection, the 1-, 3-, and 5-year DFS and OS  rates were  not statistically significant even after neoadjuvant chemotherapy.:  R1 resection showed a similar marginal recurrence rate and comparable DFS and OS  compared to R0 resection. R1 resection should be part of the modern multidisciplinary, aggressive approach to CRLM.

Biography:

Essam Dhafer Alhothaifi   Division of HBP surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea