Ronnie Tung-Ping Poon, Sheung-Tat Fan, et al (The Centre of Liver Diseases, Department of Surgery and Pathology, The University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China).
Significance of Resection Margin in Hepatectomy for Hepatocellular Carcinoma.
A Critical Reappraisal
Annals of Surgery, April 2000, 231(4), 544-551.
This study evaluates the influence of the width and the histologic involvement of the resection margin on postoperative recurrence after resection of hepatocellular carcinoma (HCC).
288 patients with macroscopically complete resection of HCC were divided into 2 groups with narrow (< 1cm) or wide (³ 1cm) resection margins, and compared.
The recurrence rates were similar between the two groups and they were similar in other clinicopathologic variables.
Most recurrences occurred away from the resection margin or at multiple sites. Those who had histologically involved resection margin or venous tumour emboli or multisatellites had higher recurrence rates then those without.
However, a positive histologic margin was not a significant risk factor for recurrence by multivariate analysis. The tumour stage and the perioperative transfusion were the only independent risk factor.
They conclude that the width of the resection margin did not influence the post-operative recurrence rate after hepatectomy for HCC. Most recurrences were considered to arise from venous dissemination.