Source
Department of Surgery-Liver Unit, Scientific Institute H San Raffaele, Vita-Salute San Raffaele University, Milan, Italy. guzzetti.eleonora@hsr.it
Abstract
BACKGROUND:
Wedge resection (WR) for colorectal liver metastases (CLM) has become more common in an attempt to preserve liver parenchyma. However, some investigator have reported that WR is associated with a higher incidence of positive margin and an inferior survival compared with anatomic resection (AR) 1.
OBJECTIVES:
This study evaluated survival, margin status, and pattern of recurrence of patients with CLM treated with WR or AR.
METHODS:
We identified 208 consecutive patients, in a single institutional database from 1995 to 2004, who underwent either WR or AR. WR was defined as a nonanatomic resection and AR was defined as single resection of one or two liver segments. Patients with combined WR-AR and patients requiring resection of more than two segments or radiofrequency ablation were excluded from the analysis.
RESULTS:
One hundred six patients underwent WR and 102 patients had AR. There were no differences in the rate of positive surgical margin (P = 0.146), overall recurrence rates (P = 0.211), and patterns of recurrence between the two groups (P = 0.468). The median survival was 32 months for WR and 42 for AR, with 5-year survival rates of 29% and 27% respectively, with no significant difference (P = 0.308). Morbidity was similar between the two groups.
CONCLUSIONS:
WR is a safe procedure and does not disadvantage the patients in terms of tumor recurrence and overall survival.
(c) 2008 Wiley-Liss, Inc.