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Prognostic significance of surgical margin in hepatocellular carcinoma resection: An analysis of 165 Childs' A patients
Author(s) -
Chau GarYang,
Lui WingYiu,
Tsay ShyhHaw,
King KuangLiang,
Loong CheChuan,
Chiu JenHwey,
Wu ChewWun,
P'eng FangKu
Publication year - 1997
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199710)66:2<122::aid-jso9>3.0.co;2-f
Subject(s) - medicine , surgical margin , hepatocellular carcinoma , wedge resection , resection margin , surgery , hepatectomy , resection , stage (stratigraphy) , surgical resection , carcinoma , clinical significance , multivariate analysis , gastroenterology , paleontology , biology
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 = 85), and a narrow margin group (<1.0 cm, group N, n = 80). Results Multivariate analysis showed that preoperative α‐fetoprotein level ( P = 0.0202), venous invasion ( P = 0.0226), surgical margin ( P = 0.0012), and TNM stage ( P = 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 = 0.0007). Group N had a higher percentage of patients undergoing minor resection (wedge resection or subsegmentectomy) (44% vs. 26%, P = 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29%, P = 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. J. Surg. Oncol. 1997;66:122–126. © 1997 Wiley‐Liss, Inc.