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Criteria for resectability of colorectal liver metastases (CRLM) have been expanded over the last decade along with the improvement in chemotherapy.Analyze the differences in several clinicopathological characteristics and overall survival (OS) between patients who underwent an R0 (tumour margin1 mm) or R1 (margin1 mm) resection.Retrospective study including 144 patients with CRLM who underwent a potentially curative liver surgery between 2010 and 2018. Patients are classified according to their surgical margin status (R0 or R1). OS and 17 clinicopathological variables are compared.Both groups are similar and comparable in all the studied variables: age (p = 0.158), sex (p = 0.675), ASA (p = 0.502), tumour location (p = 0.793), tumoral stadium (p = 0.280), post-colectomy chemotherapy (p = 0.664), CRLM synchronicity (p = 0.983) and location (p = 0.078), CEA at diagnosis (p = 0.735), neoadjuvant chemotherapy (p = 0.403), minor/major hepatectomy (p = 0.415), post-operatory complications (p = 0.822) and mortality (p = 0.535), average hospital stay (p = 0.960), post-operative chemotherapy (p = 0.791) and re-hepatectomy (p = 0.530). No significant differences are found in OS a 1, 3 and 5 years (p = 0.160) between patients with R0 and R1 resection.We consider indicated hepatectomy in any patient with resectable CRLM in whom an R0 resection can be achieved maintaining an adequate hepatic reserve, regardless of the final microscopic resection margin status.El avance en oncología ha contribuido a ampliar las indicaciones quirúrgicas de las metástasis hepáticas (MH) del carcinoma colorrectal (CCR).Analizar las diferencias en la supervivencia global (SG) y en determinadas características clinicopatológicas entre pacientes con resección R0 (margen tumoral1 mm) y R1 (margen1 mm).Estudio retrospectivo con 144 pacientes con MH de CCR intervenidos con intención curativa entre 2010 y 2018, divididos en dos grupos en función del margen de resección (R0 y R1). Se comparan la SG y 17 características clinicopatológicas.Ambos grupos son homogéneos y comparables en todas las variables estudiadas: edad (p = 0.158), sexo (p = 0.675), ASA (p = 0.502), localización del CCR (p = 0.793), estadio tumoral (p = 0.280), quimioterapia (QT) adyuvante poscolectomía (p = 0.664), sincronicidad (p = 0.983) y localización (p = 0.078) de las MH, CEA al diagnóstico (p = 0.735), QT neoadyuvante (p = 0.403), hepatectomía mayor/menor (p = 0.415), complicaciones (p = 0.822) y mortalidad posoperatorias (p = 0.535), estancia media (p = 0.960), QT adyuvante poshepatectomía (p = 0.791) y nueva hepatectomía (p = 0.530). Tampoco se observaron diferencias significativas en la SG a 1, 3 y 5 años (p = 0.160) entre pacientes con resección R0 y R1.Consideramos indicada la hepatectomía en pacientes con MH resecables con posibilidad de conseguir resecciones R0 manteniendo suficiente remanente hepático, independientemente de la afectación microscópica final del margen tumoral.

Intrabiliary growth of colorectal liver metastasis determines their capability of dissemination and relapse.65-year-old woman underwent sigmoidectomy (2011) and left hepatectomy due to liver metastases affecting the bile tract (2014). In 2020 she developed a 2cm tumour in the union of both hepatic ducts. Cholangiocarcinoma was suspected so resection of the main bile duct, the caudate lobe and lymphadenectomy were performed. On immunohistochemical examination, colorectal liver metastasis was confirmed.Liver metastases should be considered as the most likely diagnosis when bile duct dilatation or intrabiliary growth is seen in patients with a history of colorectal cancer.El crecimiento biliar de las metástasis hepáticas del cáncer colorrectal (CCR) puede influir en su diseminación y recidiva.Mujer de 65 años con antecedente de CCR (2011) y hepatectomía izquierda (2014) por metástasis hepática con afectación de la vía biliar. En 2020 desarrolló una lesión de 2 cm en la unión de los conductos hepáticos. Sospechando un colangiocarcinoma, se resecaron la vía biliar principal y el lóbulo caudado, asociando linfadenectomía. El estudio inmunohistoquímico confirmó el origen intestinal.Una imagen de dilatación o crecimiento biliar en pacientes con antecedente de CCR debe orientar a una recidiva, aunque la imagen sugiera colangiocarcinoma.

Introduction Intrabiliary growth of colorectal liver metastasis determines their capability of dissemination and relapse. Case report 65-year-old woman underwent sigmoidectomy (2011) and left hepatectomy due to liver metastases affecting the bile tract (2014). In 2020 she developed a 2cm tumour in the union of both hepatic ducts. Cholangiocarcinoma was suspected so resection of the main bile duct, the caudate lobe and lymphadenectomy were performed. On immunohistochemical examination, colorectal liver metastasis was confirmed. Conclusions Liver metastases should be considered as the most likely diagnosis when bile duct dilatation or intrabiliary growth is seen in patients with a history of colorectal cancer.