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Dig Surg. 2018;35(6):520-531. doi: 10.1159/000485805. Epub 2018 Jan 17.

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma.

Author information

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.

KEYWORDS:

Hepatocellular carcinoma; Recurrence; Resection margin; Restricted cubic spline

PMID:
29342456
DOI:
10.1159/000485805
[Indexed for MEDLINE]

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