PROGNOSTIC-SIGNIFICANCE OF SURGICAL MARGIN IN HEPATOCELLULAR-CARCINOMA RESECTION - AN ANALYSIS OF 165 CHILDS-A PATIENTS

Background and Objectives: The clinical significance of the width of t he surgical margin in the resection of hepatocellular carcinoma (HCC) has yet to be clarified. Methods: Childs' A patients (165) who underwe nt resections of HCC were studied. Patients were divided into a wide m argin group (1.0 cm or more, group W, n = 85), and a narrow margin gro up (<1.0 cm, group N, n = 80). Results: Multivariate analysis showed t hat preoperative alpha-fetoprotein level (P = 0.0202), venous invasion (P = 0.0226), surgical margin (P = 0.0012), and TNM stage (P = 0.0023 ) were significant predictors of disease-free survival. By the log-ran k test, the disease-free survival rate of the group W patients was sig nificantly higher than that of the group N patients (P = 0.0007). Grou p N had a higher percentage of patients undergoing minor resection (we dge resection or subsegmentectomy) (44% vs. 26%, P = 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29 %, P = 0.000) than group W. Conclusions: The results of this study ind icated the significant influence of surgical margin on HCC recurrence after resection. Minor resection and centrally located tumor are facto rs related to a narrow surgical margin. (C) 1997 Wiley-Liss, Inc.