Impact of marginal resection for hepatocellular carcinoma.

Abstract

The surgical margin for liver resection to treat hepatocellular carcinoma (HCC) is occasionally < 1mm. This study determined the impact of a surgical margin < 1mm [marginal resection (MR)] on the types of recurrence and the prognosis in solitary HCC. The data of 454 patients undergoing curative liver resection for solitary HCC in our institution were analyzed. The patients were divided into the MR (n = 90) and non-MR (n = 364) groups. The clinicopathological data and outcomes after liver resection were compared. A case-matching analysis using a propensity scoring method was also performed. The recurrence-free survival was significantly and overall survival was marginally significantly lower in the MR group than in the non-MR group (p = 0.012-0.051, respectively). According to a multivariate analysis, MR was not a significant independent factor for recurrence-free survival (p = 0.056). After propensity score matching, there were no significant differences in the recurrence-free and overall survival between the two groups (p = 0.375-0.496, respectively). Furthermore, there were no significant differences in the intrahepatic recurrence patterns between the two groups before and after matching. MR for solitary HCC might be sufficient in patients with a limited liver functional reserve.