Author(s) :

Saket Subramaniam.

Volume/Issue :

Abstract :

Surgery is by far the most effective treatment for patients with Colorectal Cancer Liver Metastases (CRLM). Furthermore, numerous studies have shown that surgical margins significantly impact patient survival and should be systematically evaluated. Given the modern era of chemotherapy, this review focuses on millimetre surgical margins and their impact on survival. A systematic search of 200 reports yielded 53 studies, and data on Overall Survival (OS) or Disease-Free Survival (DFS) stratified by surgical margin were collected. A Kruskal–Wallis test was conducted to compare the surgical margin subgroups: R1 (0 mm), less than 1 mm, 1–5 mm, 5–10 mm, and greater than 10 mm. A meta-analysis was used to compare the pairs R0 (greater than 0 mm)/R1 (0 mm) and greater than 1 mm/less than 1 mm. All four meta-analyses reported a significant difference (p less than 0.01) between the pairs R0/R1 and greater than 1 mm/less than 1 mm, with 95% confidence intervals and prediction intervals not crossing the null line. The findings suggest a survival benefit of R0 resection with a minimum 1 mm margin. However, due to the current limitations of this review, we cannot draw a clinical conclusion regarding the optimal surgical margin to maximise survival in patients with CRLM.