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08.04.2021 | Hepatobiliary Tumors

Infiltrative Tumor Borders in Colorectal Liver Metastasis: Should We Enlarge Margin Size?

verfasst von: Vitoria Ramos Jayme, MD, Gilton Marques Fonseca, MD, PhD, Isaac Massaud Amim Amaral, MD, Fabricio Ferreira Coelho, MD, PhD, Jaime Arthur Pirola Kruger, MD, PhD, Vagner Birk Jeismann, MD, Rafael Soares Nunes Pinheiro, MD, PhD, Evandro Sobroza de Mello, MD, PhD, Paulo Herman, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2021

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Abstract

Background

Surgery is the only potentially curative treatment for colorectal cancer liver metastases (CRLMs). Despite an improvement in results following resection, recurrence rates remain high. Many histopathological features have been reported as prognostic factors. Infiltrative borders are known to be associated with worse prognosis; however, margin size has never been evaluated together with the type of tumor border. In the present study, we analyzed the prognosis of patients with resected CRLM according to tumor growth pattern (TGP) and whether a larger margin size would bring any prognostic benefit.

Patients and Methods

Medical records from a prospective database of 645 patients who underwent hepatic resection for CRLM between January 2004 and December 2019 at a single center were reviewed, and 266 patients were included in the analytic cohort. TGP (pushing or infiltrative) was evaluated regarding the impact in overall and disease-free survival. The impact of margin size (≤ or > 1 cm) on survival and hepatic recurrence according to TGP was also evaluated.

Results

TGP was defined as infiltrative in 182 cases (68.4%) and pushing in 84 patients (31.6%). Patients with infiltrative-type border presented worse overall survival and disease-free survival, as well as higher intrahepatic recurrence (p < 0.05). Larger margin size did not impact the prognosis of patients with infiltrative borders.

Conclusions

Patients with infiltrative-type border present worse prognosis and higher intrahepatic recurrence. Larger margin size (> 1 cm) does not change the prognosis in patients with infiltrative border, showing that tumor biology is the most important factor for survival.

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Titel: Infiltrative Tumor Borders in Colorectal Liver Metastasis: Should We Enlarge Margin Size?
verfasst von: Vitoria Ramos Jayme, MD
Gilton Marques Fonseca, MD, PhD
Isaac Massaud Amim Amaral, MD
Fabricio Ferreira Coelho, MD, PhD
Jaime Arthur Pirola Kruger, MD, PhD
Vagner Birk Jeismann, MD
Rafael Soares Nunes Pinheiro, MD, PhD
Evandro Sobroza de Mello, MD, PhD
Paulo Herman, MD, PhD
Publikationsdatum: 08.04.2021
Verlag: Springer International Publishing
Erschienen in: Annals of Surgical Oncology / Ausgabe 12/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-09916-w

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Abstract

Background

Patients and Methods

Results

Conclusions

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