Hepatectomy for Solitary Hepatocellular Carcinoma: Resection Margin Width Does Not Predict Survival

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Gastroenterology

Background:

• The survival benefit of negative margins in hepatocellular carcinoma (HCC) surgery is established.
• Optimal resection margin width for HCC remains debated.
• This study investigates the impact of margin width on HCC patient survival outcomes.

Purpose of the Study:

• To assess the impact of hepatic resection margin width for solitary HCC on overall survival (OS), recurrence-free survival (RFS), and liver-specific recurrence-free survival (LSRFS).

Main Methods:

• Retrospective collection of clinicopathologic data from solitary HCC patients who underwent hepatectomy with negative margins (1992-2015).
• Categorization of margin width into tertiles: narrow (≤0.3 cm), intermediate (0.31-1.0 cm), and wide (>1.0 cm).
• Comparison of survival outcomes among the defined margin width groups.

Main Results:

• No significant differences in median OS (p=0.87), RFS (p=0.66), or LSRFS (p=0.87) were observed among narrow, intermediate, and wide margin groups.
• Multivariate analyses confirmed that margin width was not associated with OS (p=0.77), RFS (p=0.74), or LSRFS (p=0.92).
• These findings remained consistent across various subgroups, including tumor size, microvascular invasion, and resection type.

Conclusions:

• Narrow resection margins (≤0.3 cm) are oncologically safe for HCC surgery.
• The feasibility of achieving wide margins should not influence the decision regarding resectability in HCC patients.