BACKGROUND: The aim of this study was to investigate whether <5 mm as the narrowest margin width may negatively affect a patient's outcome. METHODS: A prospective cohort study was designed. From January 1994 to July 2010, 196 patients with hepatocellular carcinoma undergoing central hepatectomy were divided into group A (n = 172; narrowest margin, ≥5 to <10 mm) and group B (n = 24; narrowest margin, <5 mm), and outcomes were compared. RESULTS: Significant differences between groups A and B included tumor size (P = .057), infiltrative border (P = .021), satellite lesions (P = .021), and major perivascular abutment (P = .028). Marginal recurrence occurred in 50% of the patients in group B but none of those in group A (P < .001). There were no significant differences between the groups regarding recurrence, recurrence-related death, disease-free survival, and speed of recurrence, but a borderline significant difference was found regarding the cumulative probability of overall survival. After excluding early recurrence (within 1 year), group B had significantly lower cumulative probabilities of disease-free survival (P = .020) and overall survival (P < .001). CONCLUSIONS: In central resections, narrowest margin width of <5 mm does not negatively affect recurrence and overall survival. However, it increases perimargin recurrence and inversely affects late outcomes.
BACKGROUND: The aim of this study was to investigate whether <5 mm as the narrowest margin width may negatively affect a patient's outcome. METHODS: A prospective cohort study was designed. From January 1994 to July 2010, 196 patients with hepatocellular carcinoma undergoing central hepatectomy were divided into group A (n = 172; narrowest margin, ≥5 to <10 mm) and group B (n = 24; narrowest margin, <5 mm), and outcomes were compared. RESULTS: Significant differences between groups A and B included tumor size (P = .057), infiltrative border (P = .021), satellite lesions (P = .021), and major perivascular abutment (P = .028). Marginal recurrence occurred in 50% of the patients in group B but none of those in group A (P < .001). There were no significant differences between the groups regarding recurrence, recurrence-related death, disease-free survival, and speed of recurrence, but a borderline significant difference was found regarding the cumulative probability of overall survival. After excluding early recurrence (within 1 year), group B had significantly lower cumulative probabilities of disease-free survival (P = .020) and overall survival (P < .001). CONCLUSIONS: In central resections, narrowest margin width of <5 mm does not negatively affect recurrence and overall survival. However, it increases perimargin recurrence and inversely affects late outcomes.
Authors: Ser Yee Lee; Eran Sadot; Joanne F Chou; Mithat Gönen; Thomas Peter Kingham; Peter J Allen; Ronald P DeMatteo; William R Jarnagin; Michael I D'Angelica Journal: HPB (Oxford) Date: 2015-09-10 Impact factor: 3.647
Authors: Ryan Hickey; Michael Vouche; Daniel Y Sze; Elias Hohlastos; Jeremy Collins; Todd Schirmang; Khairuddin Memon; Robert K Ryu; Kent Sato; Richard Chen; Ramona Gupta; Scott Resnick; James Carr; Howard B Chrisman; Albert A Nemcek; Robert L Vogelzang; Robert J Lewandowski; Riad Salem Journal: J Vasc Interv Radiol Date: 2013-06-28 Impact factor: 3.464