Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for Colorectal Liver Metastases

• Published in: Journal of gastrointestinal surgery 2022-04, Vol.26 (4), p.791-801
• Main Authors: Nishioka, Yujiro, Paez-Arango, Natalia, Boettcher, Federico Oppliger, Kawaguchi, Yoshikuni, Newhook, Timothy E., Chun, Yun Shin, Tzeng, Ching-Wei D., Tran Cao, Hop S., Lee, Jeffrey E., Vreeland, Timothy J., Vauthey, Jean-Nicolas
• Format: Article
• Language: English
• Subjects: Ablation; Chemotherapy; Colorectal Neoplasms - pathology; Gastroenterology; Gastrointestinal surgery; Hepatectomy; Humans; Liver; Liver Neoplasms - genetics; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Margins of Excision; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Mutation; Neoplasm Recurrence, Local - pathology; Original Article; Prognosis; Surgery; Survival Rate; Tumors
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-021-05173-0

Background We evaluated the associations of surgical margin status and somatic mutations with the incidence of local recurrence (LR) and oncologic outcomes in patients undergoing R0-intent (microscopically negative margin) resection of colorectal liver metastases (CLM). Methods Patients with CLM who underwent initial R0-intent resection and analysis of tumor tissue using next-generation sequencing during 2001–2018 were analyzed. Recurrences were classified as LR (at the resection margin), other intrahepatic recurrence, or extrahepatic recurrence. Predictors and survival effect of LR were evaluated using univariate and multivariate analysis. Results Of 552 patients analyzed, 415 (75%) had R0 resection (margin width ≥ 1.0 mm), and 38 (7%) had LR. LR incidence was not affected by surgical margin width. RAS / TP53 co-mutation was associated with increased risk of intrahepatic recurrence (67% vs. 49%; p