Resection margins for colorectal metastases to the liver: do they make a difference?

Objective

The authors determined an appropriate surgical treatment for liver metastases from colorectal cancers. Clinicopathologic featuresof metastatic lesions of colorectal cancers were studied. Summary Background Data: Major hepatic resection is the usual procedure for treatment of hepatic metastases from colorectal cancers.

Methods

Forty consecutive patients who underwent hepatic resections were prospectively studied, for a total of 89 metastatic liver tumors.

Results

Metastatic tumor often extended along Glisson’s capsule, including invasion to the portal vein (9 cases), the hepatic vein (3 cases), the bile duct (16 cases), and the nerve (6 cases). The main tumor had small satellite nodules in only one patient, and there were no microscopic deposits in the parenchyma, even within 10 mm from the metastatic tumors. Fibrous pseudocapsule formation was observed in 28 patients. Discussion: The rarity of intrahepatic metastasis from metastatic tumor supports nonanatomic limited hepatic resection as the procedure of choice for metastatic colorectal cancer in the liver. The spread via Glisson's capsule should be taken into consideration for complete tumor clearance.