The impact of resection margin on overall survival for patients with colon cancer liver metastasis varied according to the primary cancer location

John C. McVey, Kazunari Sasaki, Georgios A. Margonis, Amy S. Nowacki, Daniel J. Firl, Jin He, Eren Berber, Christopher Wolfgang, Charles C. Miller, Matthew J Weiss, Federico N. Aucejo

Research output: Contribution to journalArticle

Abstract

Introduction: Investigation into right and left-sided primary colon liver metastasis (CLM) has revealed differences in the tumor biology and prognosis. This indicates that preoperative and operative factors may affect outcomes of right-sided primary CLM differently than left. This retrospective analysis investigated the effects of resection margin stratified by left and right-sided primary CLM on overall survival (OS) for patients undergoing hepatectomy. Methods: A total of 732 patients undergoing hepatic resection for CLM at the Cleveland Clinic and Johns Hopkins were identified between 2002 and 2016. Clinically significant variables were analyzed using Cox proportional hazard regression. The cohort was then divided into patients with right and left-sided CLM and analyzed separately using Kaplan Meier analysis and Cox proportional hazard regression. Results: Cox proportional hazard regression showed that left-sided CLM with an R0 margin was a statistically significant predictor of OS even after controlling for other important factors (HR = 0.629, P = 0.024) but right-sided CLM with R0 margin was not (HR = 0.788, P = 0.245). Kaplan–Meier analysis demonstrated that patients with a left-sided CLM and R0 margin had the best prognosis (P = 0.037). Conclusion: Surgical margin is an important prognostic factor for left-sided primary CLM but tumor biology may override surgical technique for right-sided CLM. Abstract

Original languageEnglish (US)
JournalHPB
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Liver Neoplasms
Colonic Neoplasms
Colon
Neoplasm Metastasis
Survival
Liver
Neoplasms
Margins of Excision
Kaplan-Meier Estimate
Patient Rights
Hepatectomy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

The impact of resection margin on overall survival for patients with colon cancer liver metastasis varied according to the primary cancer location. / McVey, John C.; Sasaki, Kazunari; Margonis, Georgios A.; Nowacki, Amy S.; Firl, Daniel J.; He, Jin; Berber, Eren; Wolfgang, Christopher; Miller, Charles C.; Weiss, Matthew J; Aucejo, Federico N.

In: HPB, 01.01.2018.

Research output: Contribution to journalArticle

McVey, John C. ; Sasaki, Kazunari ; Margonis, Georgios A. ; Nowacki, Amy S. ; Firl, Daniel J. ; He, Jin ; Berber, Eren ; Wolfgang, Christopher ; Miller, Charles C. ; Weiss, Matthew J ; Aucejo, Federico N. / The impact of resection margin on overall survival for patients with colon cancer liver metastasis varied according to the primary cancer location. In: HPB. 2018.
@article{2b0cedaa0bed4fa1966e41da7e364639,
title = "The impact of resection margin on overall survival for patients with colon cancer liver metastasis varied according to the primary cancer location",
abstract = "Introduction: Investigation into right and left-sided primary colon liver metastasis (CLM) has revealed differences in the tumor biology and prognosis. This indicates that preoperative and operative factors may affect outcomes of right-sided primary CLM differently than left. This retrospective analysis investigated the effects of resection margin stratified by left and right-sided primary CLM on overall survival (OS) for patients undergoing hepatectomy. Methods: A total of 732 patients undergoing hepatic resection for CLM at the Cleveland Clinic and Johns Hopkins were identified between 2002 and 2016. Clinically significant variables were analyzed using Cox proportional hazard regression. The cohort was then divided into patients with right and left-sided CLM and analyzed separately using Kaplan Meier analysis and Cox proportional hazard regression. Results: Cox proportional hazard regression showed that left-sided CLM with an R0 margin was a statistically significant predictor of OS even after controlling for other important factors (HR = 0.629, P = 0.024) but right-sided CLM with R0 margin was not (HR = 0.788, P = 0.245). Kaplan–Meier analysis demonstrated that patients with a left-sided CLM and R0 margin had the best prognosis (P = 0.037). Conclusion: Surgical margin is an important prognostic factor for left-sided primary CLM but tumor biology may override surgical technique for right-sided CLM. Abstract",
author = "McVey, {John C.} and Kazunari Sasaki and Margonis, {Georgios A.} and Nowacki, {Amy S.} and Firl, {Daniel J.} and Jin He and Eren Berber and Christopher Wolfgang and Miller, {Charles C.} and Weiss, {Matthew J} and Aucejo, {Federico N.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.hpb.2018.11.001",
language = "English (US)",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - The impact of resection margin on overall survival for patients with colon cancer liver metastasis varied according to the primary cancer location

AU - McVey, John C.

AU - Sasaki, Kazunari

AU - Margonis, Georgios A.

AU - Nowacki, Amy S.

AU - Firl, Daniel J.

AU - He, Jin

AU - Berber, Eren

AU - Wolfgang, Christopher

AU - Miller, Charles C.

AU - Weiss, Matthew J

AU - Aucejo, Federico N.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Investigation into right and left-sided primary colon liver metastasis (CLM) has revealed differences in the tumor biology and prognosis. This indicates that preoperative and operative factors may affect outcomes of right-sided primary CLM differently than left. This retrospective analysis investigated the effects of resection margin stratified by left and right-sided primary CLM on overall survival (OS) for patients undergoing hepatectomy. Methods: A total of 732 patients undergoing hepatic resection for CLM at the Cleveland Clinic and Johns Hopkins were identified between 2002 and 2016. Clinically significant variables were analyzed using Cox proportional hazard regression. The cohort was then divided into patients with right and left-sided CLM and analyzed separately using Kaplan Meier analysis and Cox proportional hazard regression. Results: Cox proportional hazard regression showed that left-sided CLM with an R0 margin was a statistically significant predictor of OS even after controlling for other important factors (HR = 0.629, P = 0.024) but right-sided CLM with R0 margin was not (HR = 0.788, P = 0.245). Kaplan–Meier analysis demonstrated that patients with a left-sided CLM and R0 margin had the best prognosis (P = 0.037). Conclusion: Surgical margin is an important prognostic factor for left-sided primary CLM but tumor biology may override surgical technique for right-sided CLM. Abstract

AB - Introduction: Investigation into right and left-sided primary colon liver metastasis (CLM) has revealed differences in the tumor biology and prognosis. This indicates that preoperative and operative factors may affect outcomes of right-sided primary CLM differently than left. This retrospective analysis investigated the effects of resection margin stratified by left and right-sided primary CLM on overall survival (OS) for patients undergoing hepatectomy. Methods: A total of 732 patients undergoing hepatic resection for CLM at the Cleveland Clinic and Johns Hopkins were identified between 2002 and 2016. Clinically significant variables were analyzed using Cox proportional hazard regression. The cohort was then divided into patients with right and left-sided CLM and analyzed separately using Kaplan Meier analysis and Cox proportional hazard regression. Results: Cox proportional hazard regression showed that left-sided CLM with an R0 margin was a statistically significant predictor of OS even after controlling for other important factors (HR = 0.629, P = 0.024) but right-sided CLM with R0 margin was not (HR = 0.788, P = 0.245). Kaplan–Meier analysis demonstrated that patients with a left-sided CLM and R0 margin had the best prognosis (P = 0.037). Conclusion: Surgical margin is an important prognostic factor for left-sided primary CLM but tumor biology may override surgical technique for right-sided CLM. Abstract

UR - http://www.scopus.com/inward/record.url?scp=85057293047&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057293047&partnerID=8YFLogxK

U2 - 10.1016/j.hpb.2018.11.001

DO - 10.1016/j.hpb.2018.11.001

M3 - Article

C2 - 30501989

AN - SCOPUS:85057293047

JO - HPB

JF - HPB

SN - 1365-182X

ER -