Zhou Zewen, Qi Lunan, Mo Qiuyan, Liu Yingchun, Zhou Xianguo, Zhou Zihan, Liang Xiumei, Feng Shixiong, Yu Hongping
Guangxi Medical University Cancer Hospital, Nanning 530021, China.
School of Public Health, Guangxi Medical University, Nanning 530021, China.
J Cancer. 2021 May 27;12(15):4455-4462. doi: 10.7150/jca.57896. eCollection 2021.
The effect of surgical margin (SM) on the postoperative prognosis of patients with solitary hepatocellular carcinoma (HCC) remains controversial. This study aimed to evaluate the effect of SM on the postoperative prognosis of patients with solitary HCC by using propensity score matching (PSM). Patients with solitary HCC who underwent liver resection were divided into a wide margin group (1.0 cm or more, group W) and a narrow margin group (< 1.0 cm, group N). Progression-free survival (PFS) and overall survival (OS) associated with the SM status and the factors influencing postoperative prognosis were evaluated. Before PSM, the indicators were not balanced between the two groups. PFS and OS were significantly lower in group N than group W. The factors affecting postoperative prognosis were international normalized ratio (INR), AST, capsule integrity, microvascular invasion, tumour embolus and tumour size. After PSM, data of both groups were balanced and comparable, and no significant differences in OS or PFS between the two groups. The INR in the above affecting factors was excluded. For solitary HCC patients with negative SMs, SM size does not affect prognosis. INR, AST, capsule integrity, microvascular invasion, tumour embolus and tumour size are independent factors influencing the postoperative prognosis of solitary HCC patients.
手术切缘（SM）对孤立性肝细胞癌（HCC）患者术后预后的影响仍存在争议。本研究旨在通过倾向评分匹配（PSM）评估SM对孤立性HCC患者术后预后的影响。将接受肝切除术的孤立性HCC患者分为宽切缘组（1.0 cm或以上，W组）和窄切缘组（<1.0 cm，N组）。评估与SM状态相关的无进展生存期（PFS）和总生存期（OS）以及影响术后预后的因素。在PSM之前，两组之间的指标不均衡。N组的PFS和OS显著低于W组。影响术后预后的因素有国际标准化比值（INR）、谷草转氨酶（AST）、包膜完整性、微血管侵犯、肿瘤栓子和肿瘤大小。PSM后，两组数据均衡且具有可比性，两组之间的OS或PFS无显著差异。上述影响因素中的INR被排除。对于SM阴性的孤立性HCC患者，SM大小不影响预后。INR、AST、包膜完整性、微血管侵犯、肿瘤栓子和肿瘤大小是影响孤立性HCC患者术后预后的独立因素。
