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Updated: May 5, 2026
The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
Tumor burden score determines survival benefit of anatomic resection in hepatocellular carcinoma: A multicenter
Shujie Pang1, Yang Shi1, Minjun Jiang1
1Department V of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, 201805, China.
Background:
The survival benefit of wide-margin or anatomic resection for hepatocellular carcinoma (HCC) is debated, necessitating practical preoperative predictors.
Methods:
This multicenter retrospective study analyzed 635 HCC patients (2016-2023) comparing recurrence-free survival (RFS) after wide vs. narrow margin and anatomic vs. non-anatomic resections. Tumor burden score (TBS) was defined as √[(max diameter)2+ (tumor number)2]. Patients were stratified by TBS (high >5, low ≤5). Propensity score matching (PSM) balanced confounders in the high-TBS cohort for RFS comparison.
Results:
Margin width did not affect RFS. Anatomic resection significantly improved RFS only in high-TBS patients (p = 0.002), not in low-TBS patients. After PSM adjusted for baseline imbalances in the high-TBS cohort, the RFS benefit of anatomic resection remained significant (p = 0.012).
Conclusion:
TBS is an effective preoperative predictor, identifying high tumor burden patients who derive significant RFS benefit from anatomic resection.
