HEPATIC RESECTION WITH CRYOTHERAPY TO INVOLVED OR INADEQUATE RESECTION MARGIN (EDGE FREEZE) FOR METASTASES FROM COLORECTAL-CANCER

Background In patients undergoing liver resection for colorectal liver metastases, a resection edge either involved by tumour or with the tu mour extending to within 1 cm is associated with a high risk of liver recurrence and survival is reduced markedly. Methods Twenty-six patien ts underwent cryotherapy of the resection edge following liver resecti on for metastases from colorectal carcinoma with an involved or inadeq uate (less than 1 cm) resection margin. Results At a median follow-up of 23 (range 1-47) months four patients were alive and disease free, a nd 21 had developed recurrence, of whom 13 had died. One patient died following surgery. Sixteen patients developed recurrences involving th e liver, only five of which were at the resection margin. Conclusion C ryotherapy to involved or inadequate resection margins improves local disease control considerably. The use of resection edge cryotherapy mi ght allow a greater proportion of patients with liver metastases to be usefully treated and help to avoid high-risk resections.