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Background: The gold standard of treatment for hepatic colorectal metastases is radical surgical resection with R0 margins. In fact positive surgical margins are associated to a higher incidence of recurrences and lower survival rates. The primary aim of this prospective study was to evaluate the presence of predictors of residual neoplastic tissue in surgical resection margins in patients who underwent preoperative chemotherapy.Patients and methods: 87 consecutive patients that underwent liver resection for colorectal metastases in our unit from January 2005 till December 2009 were enrolled. The patients were divided into 2 groups: group 1 with 48 patients (55%) that underwent liver resection after preoperative chemotherapy and group 2 with 39 patients (45%) that underwent liver resection alone. The following parameters were taken into consideration: age, sex, primary tumor site, type of operation, tumor stage, grading of primary tumor, surgical margins classified as R0, R1 and R2. Univariate and multivariate analyses were performed.Results: Patients that underwent preoperative chemotherapy had a higher probability of positive surgical margins (R1 or R2) and subsequently a non radical operation compared to patients that underwent surgery alone (OR=2.05). This result did not reach statistical significance because the incidence of R1 and R2 margins was low in both groups (7 patients in group 1 versus 3 patients in gruop 2). There was no association between radical resection and type of operation (p=0.25) or between radical resection and tumor stage. Positive surgical margins correlated significantly with primary tumor grade (Kendall’s tau b 0.157; OR 4.8).Conclusions: The grading of the primary tumor seems to be significantly associated to positive surgical resection following liver resection for colorectal metastases. A higher grading probably determines the presence of micrometastases and therefore a higher incidence of positive surgical margins.