The prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

OBJECTIVE

To evaluate the prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

DESIGN

Retrospective study.

SETTING

The Center for Adult Diseases, Osaka, Japan, between 1980 and 1989.

PATIENTS

One hundred eighty-five patients with hepatocellular carcinoma who underwent liver resection with complete extirpation.

MAIN OUTCOME MEASURE

Cumulative survival rate.

RESULTS

The patients were divided into a wide surgical margin group, in which the lesion was excised with a margin of 1.0 cm or more, and a narrow surgical margin group, in which the margin was less than 1.0 cm. No significant differences could be detected in survival rates for 3 years or longer. Mean +/- SE tumor sizes were 3.4 +/- 0.4 cm and 4.4 +/- 0.3 cm, respectively, in the wide and narrow surgical margin groups. The patients were divided into three groups according to tumor size: group 1, 2.0 cm or less in diameter; group 2, greater than 2.0 cm but 5.0 cm or less in diameter; and group 3, greater than 5.0 cm in diameter. In groups 2 and 3, no significant differences in survival rates were found between the wide and narrow surgical margin groups. In group 1, the survival rate was significantly higher in the wide surgical margin group than in the narrow surgical margin group (P < .05).

CONCLUSIONS

Small hepatocellular carcinomas of 2.0 cm or less in diameter should be resected with an adequate surgical margin. However, surgical margin was not a significant factor in the resection of hepatocellular carcinomas larger than 2.0 cm.