Prognostic significance of surgical margin in hepatocellular carcinoma resection: An analysis of 165 Childs' A patients

✍ Scribed by Chau, Gar-Yang; Lui, Wing-Yiu; Tsay, Shyh-Haw; King, Kuang-Liang; Loong, Che-Chuan; Chiu, Jen-Hwey; Wu, Chew-Wun; P'eng, Fang-Ku

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 44 KB
• Volume: 66
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199710)66:2<122::aid-jso9>3.0.co;2-f

✦ Synopsis

Background and Objectives:

The clinical significance of the width of the surgical margin in the resection of hepatocellular carcinoma (HCC) has yet to be clarified. Methods: Childs' A patients (165) who underwent resections of HCC were studied. Patients were divided into a wide margin group (1.0 cm or more, group W, n ‫ס‬ 85), and a narrow margin group (<1.0 cm, group N, n ‫ס‬ 80). Results: Multivariate analysis showed that preoperative ␣-fetoprotein level (P ‫ס‬ 0.0202), venous invasion (P ‫ס‬ 0.0226), surgical margin (P ‫ס‬ 0.0012), and TNM stage (P ‫ס‬ 0.0023) were significant predictors of disease-free survival. By the log-rank test, the disease-free survival rate of the group W patients was significantly higher than that of the group N patients (P ‫ס‬ 0.0007). Group N had a higher percentage of patients undergoing minor resection (wedge resection or subsegmentectomy) (44% vs. 26%, P ‫ס‬ 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29%, P ‫ס‬ 0.000) than group W.

Conclusions:

The results of this study indicated the significant influence of surgical margin on HCC recurrence after resection. Minor resection and centrally located tumor are factors related to a narrow surgical margin.