Reduction in recurrence risk for involved or inadequate margins with edge cryotherapy after liver resection for colorectal metastases

Hypothesis: The usefulness of additional edge cryotherapy after liver resec tion for liver metastases from colorectal cancer to improve involved or ina dequate (less than 1 cm) margins is uncertain. Design: Retrospective analysis of prospectively collected data. Setting: Department of surgery at a university hospital. Patients: Eighty-six consecutive patients with hepatic metastases from colo rectal cancer in whom we applied additional edge cryotherapy to involved or inadequate margins. This group was compared with 134 patients who underwen t resection without edge cryotherapy (control group) during the same period . Intervention: Potentially curative treatment was achieved by adding edge cr yotherapy to insufficient resection sites in patients not eligible for furt her resection. Main Outcome Measures: Edge recurrence rate in the study group; validation of an additional treatment to improve curative resectability; and compariso n of morbidity and local recurrence rates with the control group. Results: At a median follow-up of 39 months, 47 patients were alive and 39 had died. Local recurrence at the resection site was diagnosed in 9 patient s (10%), of which 7 occurred in patients with involved margins and 2 in pat ients with resection margin less than I cm. Thirty-six patients (42%) exper ienced recurrence in the remnant liver. Extrahepatic recurrence occurred in 38 patients (44%), the lungs being the most common site (22 patients [26%] ). Conclusions: Edge cryotherapy is a potent additional surgical treatment opt ion in patients with liver metastases from colorectal cancer. The percentag e of patients who can be treated for cure can be increased, especially if c omplex liver surgery is demanded.