Ann Surg Oncol (2017) 24:2432–2433 DOI 10.1245/s10434-017-5908-1 EDITORIAL – HEPATOBILIARY T UMORS Positive Margins After Resection of Metastatic Colorectal Cancer in the Liver: Back to the Drawing Board? M. I. D’Angelica, MD, FACS Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY The debate over the relevance of surgical margins in even truly enucleate a tumor, which could affect outcomes patients undergoing hepatic resection for metastatic col- if you believe that technique is the issue. My own anec- orectal cancer has gone on for decades. For many years a dotal experience suggests that margins are likely more a ‘‘1-cm margin’’ rule was recommended. Based on limited reﬂection of underlying tumor growth patterns and a sur- and now outdated information, patients with margins closer rogate for underlying tumor biology. I have seen exposed than 1 cm appeared to have signiﬁcantly worse survival. tumors on the surface of a resection specimen called neg- As recently as 10 years ago, our group continued to ﬁnd ative on a pathology report, and I have seen what grossly better outcomes associated with margins greater than looks like normal liver tissue called positive on a pathology 1 cm. More recently, most studies have
Annals of Surgical Oncology – Springer Journals
Published: May 31, 2017
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