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Recurrence patterns and their effects on clinical outcomes after R1 resection of colorectal liver metastases: a propensity score–matched analysis

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Abstract

Purpose

The prognostic significance of the surgical margin status remains controversial for patients who undergo hepatectomy for colorectal liver metastases. This study evaluated the influence of R1 resection on recurrence patterns and prognosis in these patients.

Methods

Between January 2001 and December 2016, 232 consecutive Japanese patients underwent initial hepatic resection for colorectal liver metastases. Their medical records were reviewed to evaluate recurrence and survival outcomes.

Results

Relative to patients with R0 resection, patients with R1 resection had significantly poorer recurrence-free survival (RFS) and overall survival (OS). However, after propensity score matching, there were no significant differences in RFS and OS associated with the margin status. Nevertheless, R1 resection was associated with a significantly higher incidence of intrahepatic recurrence and early recurrence, while R0 resection was associated with a significantly higher re-resection rate for hepatic recurrence. Only eight of 55 patients with R1 resection developed recurrence at the R1 resection margin, whereas 36 patients developed recurrence at other sites/organs.

Conclusion

Among patients with similar characteristics, R1 resection does not affect long-term outcomes. This suggests that R1 resection itself is not a cause of a poor prognosis, but rather a potent indicator of aggressive tumor biology.

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Data and materials availability

The data that support the findings of the present study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Nozomu Sakai, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano & Masayuki Ohtsuka

Authors
  1. Nozomu Sakai
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  2. Katsunori Furukawa
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  3. Tsukasa Takayashiki
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  4. Satoshi Kuboki
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  5. Shigetsugu Takano
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  6. Masayuki Ohtsuka
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Corresponding author

Correspondence to Masayuki Ohtsuka.

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Ethics approval

The retrospective study protocol was approved by the Institutional Ethics Committee of the College of Medicine, Chiba University. Informed consent for treatment was obtained from all patients after providing them with information regarding the extent of their disease and the treatment’s risks and benefits.

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The authors declare no competing interests.

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Sakai, N., Furukawa, K., Takayashiki, T. et al. Recurrence patterns and their effects on clinical outcomes after R1 resection of colorectal liver metastases: a propensity score–matched analysis. Langenbecks Arch Surg 406, 2739–2747 (2021). https://doi.org/10.1007/s00423-021-02096-x

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  • DOI: https://doi.org/10.1007/s00423-021-02096-x

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