Open AccessSignificance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma
Author(s) -
Aoki T.,
Kubota K.,
Hasegawa K.,
Kubo S.,
Izumi N.,
Kokudo N.,
Sakamoto M.,
Shiina S.,
Takayama T.,
Nakashima O.,
Matsuyama Y.,
Murakami T.,
Kudo M.
Publication year - 2020
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.11329
Subject(s) - medicine , hepatocellular carcinoma , surgical margin , margin (machine learning) , resection margin , hepatectomy , surgical resection , resection , overall survival , surgery , carcinoma , machine learning , computer science
Background The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non‐anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non‐anatomical resection for solitary HCC. Methods Data from patients with solitary HCC who had undergone non‐anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence‐free survival associated with the surgical margin status and width were evaluated in the two groups. Results A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0‐mm surgical margin was associated with poorer overall and recurrence‐free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome. Conclusion Anatomical resection with a negative 0‐mm surgical margin may be acceptable. Non‐anatomical resection with a negative 0‐mm margin was associated with a less favourable survival outcome.