The impact of resection margin and microvascular invasion on long-term prognosis after curative resection of hepatocellular carcinoma: a multi-institutional study

被引：74

作者：

Han, Jun ^{[1
]}

Li, Zhen-Li ^{[1
]}

Xing, Hao ^{[1
]}

Wu, Han ^{[1
]}

Zhu, Peng ^{[2
]}

Lau, Wan Yee ^{[1
,3
]}

Zhou, Ya-Hao ^{[4
]}

Gu, Wei-Min ^{[5
]}

Wang, Hong ^{[6
]}

Chen, Ting-Hao ^{[7
]}

Zeng, Yong-Yi ^{[8
]}

Wu, Meng-Chao ^{[1
]}

Shen, Feng ^{[1
]}

Yang, Tian ^{[1
]}

机构：

[1] Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 20438, Peoples R China

[2] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Hepat Surg Ctr, Wuhan, Hubei, Peoples R China

[3] Chinese Univ Hong Kong, Prince Wales Hosp, Fac Med, Shatin, Hong Kong, Peoples R China

[4] Puer Peoples Hosp, Dept Hepatobiliary Surg, Puer, Yunnan, Peoples R China

[5] Fourth Hosp Harbin, Dept Gen Surg 1, Harbin, Heilongjiang, Peoples R China

[6] Liuyang Peoples Hosp, Dept Gen Surg, Liuyang City, Hunan, Peoples R China

[7] Ziyang First Peoples Hosp, Dept Gen Surg, Jianyang, Sichuan, Peoples R China

[8] Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Hepatobiliary Surg, Fuzhou, Fujian, Peoples R China

来源：

HPB | 2019年 / 21卷 / 08期

基金：

中国国家自然科学基金;

关键词：

INTRAHEPATIC RECURRENCE; SURGICAL MARGIN; RISK-FACTORS; PREOPERATIVE PREDICTION; LIVER RESECTION; MILAN CRITERIA; HEPATITIS-B; MANAGEMENT; HEPATECTOMY; PREVENTION;

D O I：

10.1016/j.hpb.2018.11.005

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: The resection margin (RM) status and microscopic vascular invasion (MVI) are known prognostic factors for hepatocellular carcinoma (HCC). An enhanced understanding of their impact on long-term prognosis is required to improve oncological outcomes. Methods: Using multi-institutional data, the different impact of the RM status (narrow, <1 cm, or wide, >= 1 cm) and MVI (positive or negative) on overall survival (OS) and recurrence-free survival (RFS) after curative liver resection of solitary HCC without macrovascular invasion was analyzed. Results: In 801 patients, 306 (38%) had a narrow RM and 352 (44%) had positive MVI. The median OS and RFS were 109.8 and 74.8 months in patients with wide RM & negative MVI, 93.5 and 53.1 months with wide RM & positive MVI, 79.2 and 41.6 months with narrow RM & negative MVI, and 69.2 and 37.5 months with narrow RM & positive MVI (both P < 0.01). On multivariable analyses, narrow RM & positive MVI had the highest hazard ratio with reduced OS and RFS (HR 2.96, 95% CI 2.11-4.17, and HR 3.15, 95% CI, 2.09-4.67, respectively). Conclusions: Concomitant having narrow RM and positive MVI increases the risks of postoperative death and recurrence by about 2-fold in patients with solitary HCC.

引用

页码：962 / 971

页数：10

共 42 条

[1] INTRAHEPATIC RECURRENCE AFTER RESECTION OF HEPATOCELLULAR-CARCINOMA COMPLICATING CIRRHOSIS [J].