[Influence of surgical resection margin in hepatectomy on survival of patients with hepatocellular carcinoma].

OBJECTIVE: To compare the effect of different resection margin in hepatectomy on recurrence and survival of patients with hepatocellular carcinoma (HCC), and to determine an appropriate resection margin of hepatectomy for HCC patients.

METHODS: 152 untreated HCC patients were randomly divided into two groups based on the distal and proximal resection margin according to direction of the portal vein flow. Seventy-four patients in the wide-margin group had a distal resection margin of 2 cm and a proximal of 1 cm away from the edge of the primary tumor, while 78 patients in the narrow-margin group had a resection margin of < 1 cm away from the edge of the primary tumor provided that the margin was proven to be histologically free of cancer cells. The distal and proximal margins were defined. The data were analyzed and compared using Kaplan-Meier survival analysis and Log rank test.

RESULTS: The mean overall survival time of patients in wide-margin group and narrow-margin group were 42.0 months and 37.5 months, respectively. The mean tumor-free survival time of these two groups of patients were 35.5 months and 28.8 months, respectively. Patients in wide-margin group had significantly longer overall survival (t = 6.23, P = 0.0125) and tumor-free survival (t = 6.01, P = 0.0142) than patients in the narrow-margin group.

CONCLUSION: In hepatectomy for hepatocellular cell carcinoma patients, wide distal resection margin of 2 cm and a proximal of 1 cm away from the edge of the primary tumors according to direction of the portal vein flow may reasonably improve the overall and tumor-free survival.