Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma
Abstract Background The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin statu...
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| Veröffentlicht in: | British journal of surgery 2020-01, Vol.107 (1), p.113-120 |
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| container_title | British journal of surgery |
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| creator | Aoki, T Kubota, K Hasegawa, K Kubo, S Izumi, N Kokudo, N Sakamoto, M Shiina, S Takayama, T Nakashima, O Matsuyama, Y Murakami, T Kudo, M |
| description | Abstract
Background
The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non-anatomical resection for solitary HCC.
Methods
Data from patients with solitary HCC who had undergone non-anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence-free survival associated with the surgical margin status and width were evaluated in the two groups.
Results
A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0-mm surgical margin was associated with poorer overall and recurrence-free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome.
Conclusion
Anatomical resection with a negative 0-mm surgical margin may be acceptable. Non-anatomical resection with a negative 0-mm margin was associated with a less favourable survival outcome.
Graphical Abstract
Data of patients in Japan with hepatocellular carcinoma who had undergone a non-anatomical or anatomical resection were extracted from a nationwide survey database. A microscopically positive margin was associated with poorer overall survival. The outcome of patients with a negative but 0-mm margin was poor only in the non-anatomical resection group, suggesting that anatomical resection with a negative 0-mm margin is acceptable.
Graphical Abstract
Difference between anatomic and non-anatomic resection |
| doi_str_mv | 10.1002/bjs.11329 |
| format | Article |
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Background
The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non-anatomical resection for solitary HCC.
Methods
Data from patients with solitary HCC who had undergone non-anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence-free survival associated with the surgical margin status and width were evaluated in the two groups.
Results
A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0-mm surgical margin was associated with poorer overall and recurrence-free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome.
Conclusion
Anatomical resection with a negative 0-mm surgical margin may be acceptable. Non-anatomical resection with a negative 0-mm margin was associated with a less favourable survival outcome.
Graphical Abstract
Data of patients in Japan with hepatocellular carcinoma who had undergone a non-anatomical or anatomical resection were extracted from a nationwide survey database. A microscopically positive margin was associated with poorer overall survival. The outcome of patients with a negative but 0-mm margin was poor only in the non-anatomical resection group, suggesting that anatomical resection with a negative 0-mm margin is acceptable.
Graphical Abstract
Difference between anatomic and non-anatomic resection</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.11329</identifier><identifier>PMID: 31654406</identifier><language>eng</language><publisher>Chichester, UK: Oxford University Press</publisher><subject>Liver cancer</subject><ispartof>British journal of surgery, 2020-01, Vol.107 (1), p.113-120</ispartof><rights>2019 BJS Society Ltd Published by John Wiley & Sons Ltd 2019</rights><rights>2019 BJS Society Ltd Published by John Wiley & Sons Ltd</rights><rights>2019 BJS Society Ltd Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 BJS Society Ltd. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3839-eaf5ed3da529920a4d3ab8a1a86184a3a889fc9a3d348a15b60c80d4e7b9dbed3</citedby><orcidid>0000-0002-2868-5246 ; 0000-0001-8734-740X ; 0000-0002-9003-8613</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.11329$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.11329$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31654406$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aoki, T</creatorcontrib><creatorcontrib>Kubota, K</creatorcontrib><creatorcontrib>Hasegawa, K</creatorcontrib><creatorcontrib>Kubo, S</creatorcontrib><creatorcontrib>Izumi, N</creatorcontrib><creatorcontrib>Kokudo, N</creatorcontrib><creatorcontrib>Sakamoto, M</creatorcontrib><creatorcontrib>Shiina, S</creatorcontrib><creatorcontrib>Takayama, T</creatorcontrib><creatorcontrib>Nakashima, O</creatorcontrib><creatorcontrib>Matsuyama, Y</creatorcontrib><creatorcontrib>Murakami, T</creatorcontrib><creatorcontrib>Kudo, M</creatorcontrib><creatorcontrib>Liver Cancer Study Group of Japan</creatorcontrib><title>Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Abstract
Background
The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non-anatomical resection for solitary HCC.
Methods
Data from patients with solitary HCC who had undergone non-anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence-free survival associated with the surgical margin status and width were evaluated in the two groups.
Results
A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0-mm surgical margin was associated with poorer overall and recurrence-free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome.
Conclusion
Anatomical resection with a negative 0-mm surgical margin may be acceptable. Non-anatomical resection with a negative 0-mm margin was associated with a less favourable survival outcome.
Graphical Abstract
Data of patients in Japan with hepatocellular carcinoma who had undergone a non-anatomical or anatomical resection were extracted from a nationwide survey database. A microscopically positive margin was associated with poorer overall survival. The outcome of patients with a negative but 0-mm margin was poor only in the non-anatomical resection group, suggesting that anatomical resection with a negative 0-mm margin is acceptable.
Graphical Abstract
Difference between anatomic and non-anatomic resection</description><subject>Liver cancer</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kctqwzAQRUVpadLHoj9QBO2iGyeS5Ye0bEOfBLpIuxZjWY4VbDm1bEL-vkqcdlEoCEbcOXcY5iJ0RcmEEhJOs5WbUMpCcYTGlCVxENKEH6MxISQNvM5G6My5FSGUkTg8RSNGkziKSDJG5cIsrSmMAqs0bgrclRq7vl16pcKlXkNnFG6106ozjcU1-JbF_u062nYOb0xXYsDO2GWlB0ujdFX1FbRYQauMbWq4QCcFVE5fHuo5-nx6_Ji9BPP359fZ_TxQjDMRaChinbMc4lCIkECUM8g4UOAJ5REw4FwUSgDLWeTlOEuI4iSPdJqJPPPOc3Q3zF23zVevXSdr43brgNVN72TIiIg482M8evMHXTV9a_12ngpF6vdJmaeuD1Sf1TqX69b4I2zlzw09MB2Ajan09rdPidyFI304ch-OfHhb7D_ecTs4mn79P8--ASryjco</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Aoki, T</creator><creator>Kubota, K</creator><creator>Hasegawa, K</creator><creator>Kubo, S</creator><creator>Izumi, N</creator><creator>Kokudo, N</creator><creator>Sakamoto, M</creator><creator>Shiina, S</creator><creator>Takayama, T</creator><creator>Nakashima, O</creator><creator>Matsuyama, Y</creator><creator>Murakami, T</creator><creator>Kudo, M</creator><general>Oxford University Press</general><general>John Wiley & Sons, Ltd</general><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2868-5246</orcidid><orcidid>https://orcid.org/0000-0001-8734-740X</orcidid><orcidid>https://orcid.org/0000-0002-9003-8613</orcidid></search><sort><creationdate>202001</creationdate><title>Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma</title><author>Aoki, T ; Kubota, K ; Hasegawa, K ; Kubo, S ; Izumi, N ; Kokudo, N ; Sakamoto, M ; Shiina, S ; Takayama, T ; Nakashima, O ; Matsuyama, Y ; Murakami, T ; Kudo, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3839-eaf5ed3da529920a4d3ab8a1a86184a3a889fc9a3d348a15b60c80d4e7b9dbed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Liver cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aoki, T</creatorcontrib><creatorcontrib>Kubota, K</creatorcontrib><creatorcontrib>Hasegawa, K</creatorcontrib><creatorcontrib>Kubo, S</creatorcontrib><creatorcontrib>Izumi, N</creatorcontrib><creatorcontrib>Kokudo, N</creatorcontrib><creatorcontrib>Sakamoto, M</creatorcontrib><creatorcontrib>Shiina, S</creatorcontrib><creatorcontrib>Takayama, T</creatorcontrib><creatorcontrib>Nakashima, O</creatorcontrib><creatorcontrib>Matsuyama, Y</creatorcontrib><creatorcontrib>Murakami, T</creatorcontrib><creatorcontrib>Kudo, M</creatorcontrib><creatorcontrib>Liver Cancer Study Group of Japan</creatorcontrib><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aoki, T</au><au>Kubota, K</au><au>Hasegawa, K</au><au>Kubo, S</au><au>Izumi, N</au><au>Kokudo, N</au><au>Sakamoto, M</au><au>Shiina, S</au><au>Takayama, T</au><au>Nakashima, O</au><au>Matsuyama, Y</au><au>Murakami, T</au><au>Kudo, M</au><aucorp>Liver Cancer Study Group of Japan</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2020-01</date><risdate>2020</risdate><volume>107</volume><issue>1</issue><spage>113</spage><epage>120</epage><pages>113-120</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><abstract>Abstract
Background
The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical or non-anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non-anatomical resection for solitary HCC.
Methods
Data from patients with solitary HCC who had undergone non-anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence-free survival associated with the surgical margin status and width were evaluated in the two groups.
Results
A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0-mm surgical margin was associated with poorer overall and recurrence-free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome.
Conclusion
Anatomical resection with a negative 0-mm surgical margin may be acceptable. Non-anatomical resection with a negative 0-mm margin was associated with a less favourable survival outcome.
Graphical Abstract
Data of patients in Japan with hepatocellular carcinoma who had undergone a non-anatomical or anatomical resection were extracted from a nationwide survey database. A microscopically positive margin was associated with poorer overall survival. The outcome of patients with a negative but 0-mm margin was poor only in the non-anatomical resection group, suggesting that anatomical resection with a negative 0-mm margin is acceptable.
Graphical Abstract
Difference between anatomic and non-anatomic resection</abstract><cop>Chichester, UK</cop><pub>Oxford University Press</pub><pmid>31654406</pmid><doi>10.1002/bjs.11329</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2868-5246</orcidid><orcidid>https://orcid.org/0000-0001-8734-740X</orcidid><orcidid>https://orcid.org/0000-0002-9003-8613</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2020-01, Vol.107 (1), p.113-120 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Liver cancer |
| title | Significance of the surgical hepatic resection margin in patients with a single hepatocellular carcinoma |
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