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Am J Surg. 2013 Jul;206(1):64-71. doi: 10.1016/j.amjsurg.2012.06.010. Epub 2013 Feb 4.

Is less than 5 mm as the narrowest surgical margin width in central resections of hepatocellular carcinoma justified?

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1
Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.

Abstract

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.

PMID:
23388427
DOI:
10.1016/j.amjsurg.2012.06.010
[Indexed for MEDLINE]
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