Significance of Glisson's capsule invasion in patients with colorectal liver metastases undergoing resection

Background: Significance of Glisson's capsule invasion in colorectal liver metastases (CLM) patients undergoing resection has been little investigated. Methods: CLM patients (244) with curative resection (2011-2016) were divided into two groups: patients with (Group 1; n = 49 [20%1) and without (Group 2; n = 195 [80%1) histologically-proven Glisson invasion. Eight (16%) Group 1 patients were identified by pre- or intra-operative findings. We compared characteristics between Groups 1 and 2 and determined independent prognosticators. Results: Group 1 was more commonly associated with right-sided primary, CLM>5 cm, and R1 resections. Independent factors on reduced OS in entire cohort were pre-surgical chemotherapy [hazard ratio (HR): 2.68, P = 0.001], CLM>5 cm (HR: 4.39, P = 0.002), moderate or poor differentiation (HR: 2.38, P = 0.004), and R1 resection (HR: 1.92, P = 0.035). Conclusions: CLM Glisson invasion was significantly associated with R1 resection. Advancements in determining Glisson invasion pre- or intra-operatively might produce benefits for CLM patients undergoing resection by reducing R1 resection. (C) 2019 Elsevier Inc. All rights reserved.