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Article: Significance of resection margin in hepatectomy for hepatocellular carcinoma: A critical reappraisal

TitleSignificance of resection margin in hepatectomy for hepatocellular carcinoma: A critical reappraisal
Authors
Issue Date2000
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2000, v. 231 n. 4, p. 544-551 How to Cite?
AbstractObjective: To evaluate the influence of the width and histologic involvement of the resection margin on postoperative recurrence after resection of hepatocellular carcinoma (HCC). Summary Background Data: The significance of the resection margin in hepatectomy for HCC remains controversial. A precise evaluation of the effects of the width and histologic involvement of the resection margin on postoperative recurrence is required to clarify the issue. Methods: Two hundred eighty-eight patients with macroscopically complete resection of HCC were divided into groups with narrow (<1 cm) or wide (≥1 cm) resection margins. The two groups were compared for postoperative recurrence rate and pattern of recurrence. A further analysis was performed to investigate the effects of histologic involvement of the resection margin on postoperative recurrence. Results: Recurrence rates were similar between 150 patients with a narrow margin and 138 patients with a wide margin; the groups were comparable in other clinicopathologic variables. Most recurrent tumors occurred in the liver remnant at a segment distant from the resection margin or at multiple segments. Thirty-four patients had margin involved histologically by microscopic invasion from the main tumor (n = 13), venous tumor thrombi (n = 13), or microsatellites separate from the main tumor (n = 8). These patients had significantly higher recurrence rates than those with a histologically clear margin. However, a positive histologic margin was not a significant risk factor for recurrence by multivariate analysis. Tumor stage and perioperative transfusion were the only independent risk factors. Conclusions: The width of the resection margin did not influence the postoperative recurrence rates after hepatectomy for HCC. A positive histologic margin was associated with a higher incidence of postoperative recurrence, but in most patients this was related to the underlying venous invasion or microsatellites. Most intrahepatic recurrences were considered to arise from intrahepatic metastasis by means of venous dissemination, which a wide resection margin could not prevent.
Persistent Identifierhttp://hdl.handle.net/10722/49416
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2008-06-12T06:42:01Z-
dc.date.available2008-06-12T06:42:01Z-
dc.date.issued2000en_HK
dc.identifier.citationAnnals Of Surgery, 2000, v. 231 n. 4, p. 544-551en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49416-
dc.description.abstractObjective: To evaluate the influence of the width and histologic involvement of the resection margin on postoperative recurrence after resection of hepatocellular carcinoma (HCC). Summary Background Data: The significance of the resection margin in hepatectomy for HCC remains controversial. A precise evaluation of the effects of the width and histologic involvement of the resection margin on postoperative recurrence is required to clarify the issue. Methods: Two hundred eighty-eight patients with macroscopically complete resection of HCC were divided into groups with narrow (<1 cm) or wide (≥1 cm) resection margins. The two groups were compared for postoperative recurrence rate and pattern of recurrence. A further analysis was performed to investigate the effects of histologic involvement of the resection margin on postoperative recurrence. Results: Recurrence rates were similar between 150 patients with a narrow margin and 138 patients with a wide margin; the groups were comparable in other clinicopathologic variables. Most recurrent tumors occurred in the liver remnant at a segment distant from the resection margin or at multiple segments. Thirty-four patients had margin involved histologically by microscopic invasion from the main tumor (n = 13), venous tumor thrombi (n = 13), or microsatellites separate from the main tumor (n = 8). These patients had significantly higher recurrence rates than those with a histologically clear margin. However, a positive histologic margin was not a significant risk factor for recurrence by multivariate analysis. Tumor stage and perioperative transfusion were the only independent risk factors. Conclusions: The width of the resection margin did not influence the postoperative recurrence rates after hepatectomy for HCC. A positive histologic margin was associated with a higher incidence of postoperative recurrence, but in most patients this was related to the underlying venous invasion or microsatellites. Most intrahepatic recurrences were considered to arise from intrahepatic metastasis by means of venous dissemination, which a wide resection margin could not prevent.en_HK
dc.format.extent388 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCarcinoma, Hepatocellular - drug therapy - pathology - surgeryen_HK
dc.subject.meshHepatectomyen_HK
dc.subject.meshLiver Neoplasms - drug therapy - pathology - surgeryen_HK
dc.subject.meshChemotherapy, Adjuvanten_HK
dc.subject.meshMicrosatellite Repeatsen_HK
dc.titleSignificance of resection margin in hepatectomy for hepatocellular carcinoma: A critical reappraisalen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=231&issue=4&spage=544&epage=551&date=2000&atitle=Significance+of+resection+margin+in+hepatectomy+for+hepatocellular+carcinoma:+a+critical+reappraisalen_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1097/00000658-200004000-00014en_HK
dc.identifier.pmid10749616-
dc.identifier.pmcidPMC1421031en_HK
dc.identifier.scopuseid_2-s2.0-0034034029en_HK
dc.identifier.hkuros48326-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034034029&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume231en_HK
dc.identifier.issue4en_HK
dc.identifier.spage544en_HK
dc.identifier.epage551en_HK
dc.identifier.isiWOS:000086277400014-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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