Woohyung Lee1,2, Ho-Seong Han1, Soyeon Ahn3, Yoo-Seok Yoon1, Jai Young Cho1, YoungRok Choi1. 1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea. 2. Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwong-si, Republic of Korea. 3. Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea.
Abstract
BACKGROUND: The relationship between resection margin (RM) and recurrence of resected hepatocellular carcinoma (HCC) is unclear. METHODS: We reviewed clinical data for 419 patients with HCC. The oncologic outcomes were compared between 2 groups of patients classified according to the inflexion point of the restricted cubic spline plot. RESULTS: The patients were divided according to an RM of <1 cm (n = 233; narrow RM group) or ≥1 cm (n = 186; wide RM group). The 5-year recurrence-free survival (RFS) rate was lower (34.8 vs. 43.8%, p = 0.042) and recurrence near the resection site was more frequent (4.7 vs. 0%, p = 0.010) in the narrow RM group. Patients with multiple lesions, or prior transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) were excluded from subgroup analyses. In patients with a 2-5 cm HCC, the 5-year RFS was greater in the wide RM group (54.4 vs. 32.5%, p = 0.036). Narrow RM (hazard ratio 1.750, 95% CI 1.029-2.976, p = 0.039) was independently associated with disease recurrence. CONCLUSION: In patients with a single 2-5 cm HCC without prior TACE/RFA, an RM of ≥1 cm was associated with lower risk of recurrence after liver resection.
BACKGROUND: The relationship between resection margin (RM) and recurrence of resected hepatocellular carcinoma (HCC) is unclear. METHODS: We reviewed clinical data for 419 patients with HCC. The oncologic outcomes were compared between 2 groups of patients classified according to the inflexion point of the restricted cubic spline plot. RESULTS: The patients were divided according to an RM of <1 cm (n = 233; narrow RM group) or ≥1 cm (n = 186; wide RM group). The 5-year recurrence-free survival (RFS) rate was lower (34.8 vs. 43.8%, p = 0.042) and recurrence near the resection site was more frequent (4.7 vs. 0%, p = 0.010) in the narrow RM group. Patients with multiple lesions, or prior transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) were excluded from subgroup analyses. In patients with a 2-5 cm HCC, the 5-year RFS was greater in the wide RM group (54.4 vs. 32.5%, p = 0.036). Narrow RM (hazard ratio 1.750, 95% CI 1.029-2.976, p = 0.039) was independently associated with disease recurrence. CONCLUSION: In patients with a single 2-5 cm HCC without prior TACE/RFA, an RM of ≥1 cm was associated with lower risk of recurrence after liver resection.
Authors: Woohyung Lee; Chi-Young Jeong; Young Hoon Kim; Young Hoon Roh; Myung Hee Yoon; Hyung Il Seo; Jeong-Ik Park; Bo-Hyun Jung; Dong Hoon Shin; Young Il Choi; Je Ho Ryu; Kwang Ho Yang; Chang Soo Choi; Yo-Han Park; Yang Won Nah; Soon-Chan Hong Journal: Langenbecks Arch Surg Date: 2019-08-14 Impact factor: 3.445