Surgical Margin in Hepatic Resections for Colorectal Metastasis: Should We Care?

Abstract

Many studies seek to define the appropriate margin width necessary to confer the best survival advantage following hepatic resection for colorectal metastatic disease. The ability to achieve at least a 1-cm tumor-free margin has historically represented one of the strongest prognostic factors determining overall outcomes and has been a necessary condition for resectability. With the advent of modern chemotherapy, the importance of surgical margin width is increasingly questioned and our understanding of its impact is evolving concomitantly to the improvement and the widespread use of more effective systemic chemotherapeutic agents. Although achieving a microscopic margin-negative resection (R0) remains the goal of surgical resection, specific tumor biology factors should be consider in deciding on the appropriate margin width. In this review, we summarize the most recent evidence regarding the importance of the surgical margin in hepatic resection for colorectal metastasis in the era of modern chemotherapy.