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J Surg Oncol. 2008 May 1;97(6):503-7. doi: 10.1002/jso.20979.

Impact of type of liver resection on the outcome of colorectal liver metastases: a case-matched analysis.

Author information

1
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.

PMID:
18425789
DOI:
10.1002/jso.20979
[Indexed for MEDLINE]

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