Impact of type of liver resection on the outcome of colorectal liver metastases: A case-matched analysis†

Background Wedge resection (WR) for colorectal liver metastases (CLM) has become more common in an attempt to preserve liver parenchyma. However, some investigator have reported that WR is associated with a higher incidence of positive margin and an inferior survival compared with anatomic resection (AR) 1. Objectives This study evaluated survival, margin status, and pattern of recurrence of patients with CLM treated with WR or AR. Methods We identified 208 consecutive patients, in a single institutional database from 1995 to 2004, who underwent either WR or AR. WR was defined as a nonanatomic resection and AR was defined as single resection of one or two liver segments. Patients with combined WR–AR and patients requiring resection of more than two segments or radiofrequency ablation were excluded from the analysis. Results One hundred six patients underwent WR and 102 patients had AR. There were no differences in the rate of positive surgical margin (P = 0.146), overall recurrence rates (P = 0.211), and patterns of recurrence between the two groups (P = 0.468). The median survival was 32 months for WR and 42 for AR, with 5-year survival rates of 29% and 27% respectively, with no significant difference (P = 0.308). Morbidity was similar between the two groups. Conclusions WR is a safe procedure and does not disadvantage the patients in terms of tumor recurrence and overall survival. J. Surg. Oncol. 2008;97:503–507. © 2008 Wiley-Liss, Inc.