When surgeons remove liver tumors, they aim for a clear margin of healthy tissue around the cancer. But sometimes getting that clear margin would mean removing too much liver. A new analysis of 839 patients looked at whether a narrower margin (called R1 vascular margin) is safe enough.
The results depend on the type of cancer. For people with hepatocellular carcinoma (HCC), the most common liver cancer, leaving a narrow margin did not increase the chance of the tumor coming back. The local recurrence rate was about 6% with a narrow margin versus 8% with a clear margin, a difference that was not statistically significant.
But for colorectal cancer that spread to the liver, the story was different. Patients who had a narrow margin had a local recurrence rate of 12%, compared to 6% with a clear margin. That difference was significant, meaning the narrow margin approach may not be safe enough for these patients.
The study also compared robotic and laparoscopic surgery and found similar recurrence rates between the two techniques. However, the evidence is not strong enough to draw firm conclusions about which approach is better. The researchers caution that more studies are needed to define clear benchmarks for when a narrow margin is acceptable.