The importance of surgical margins in primary malignancies of the liver

Lafaro, Kelly J.; Grandhi, Miral S.; Herman, Joseph M.; Pawlik, Timothy M.

doi:10.1002/jso.24123

Cited by 53 publications

(33 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the relationship between the surgical margin and the oncologic outcome is unclear in patients with HCC [5]. Although sufficient margin from the tumor is the principle of oncologic surgery, most patients with HCC have chronic liver disease or cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

et al. 2018

View full text Add to dashboard Cite

Background: The relationship between resection margin (RM) and recurrence of resected hepatocellular carcinoma (HCC) is unclear. Methods: We reviewed clinical data for 419 patients with HCC. The oncologic outcomes were compared between 2 groups of patients classified according to the inflexion point of the restricted cubic spline plot. Results: The patients were divided according to an RM of <1 cm (n = 233; narrow RM group) or ≥1 cm (n = 186; wide RM group). The 5-year recurrence-free survival (RFS) rate was lower (34.8 vs. 43.8%, p = 0.042) and recurrence near the resection site was more frequent (4.7 vs. 0%, p = 0.010) in the narrow RM group. Patients with multiple lesions, or prior transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) were excluded from subgroup analyses. In patients with a 2–5 cm HCC, the 5-year RFS was greater in the wide RM group (54.4 vs. 32.5%, p = 0.036). Narrow RM (hazard ratio 1.750, 95% CI 1.029–2.976, p = 0.039) was independently associated with disease recurrence. Conclusion: In patients with a single 2–5 cm HCC without prior TACE/RFA, an RM of ≥1 cm was associated with lower risk of recurrence after liver resection.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, the relationship between resection margin (RM) and disease recurrence is unclear. Some studies have shown that the oncologic outcomes were better in patients with a wide RM than in patients with a narrow RM; however, other studies revealed no oncologic benefits of a wide versus narrow RM [5-7]. …”

Section: Introductionmentioning

confidence: 99%

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

et al. 2018

View full text Add to dashboard Cite

show abstract

“…But in recent years, the indication was extended to those recipients over Milan criteria. In fact, there are no worldwide recognized selection criteria for LT. Due to the invasive and metastatic nature of HCC, recurrence is still the main problem after liver resection4. Patients with intrahepatic recurrence would be given an accurate assessment, and considered for salvage liver transplantation (SLT)5.…”

mentioning

confidence: 99%

Salvage Liver Transplantation Leads to Poorer Outcome in Hepatocellular Carcinoma Compared with Primary Liver Transplantation

Shan

Huang

Xia

2017

Sci Rep

View full text Add to dashboard Cite

Hepatocellular carcinoma is the most common liver malignancy. Salvage liver transplantation (SLT) is viewed as a feasible cure for recurrence of HCC after resectomy, but the effect is under dispute. A retrospective study examined data at Renji Hospital for 239 transplants from January 2006 to December 2015, including 211 who received primary liver transplantation (PLT) and 28 who underwent SLT. A multivariable cox regression model was employed to pick out relative factors to overall survival (OS) and recurrence free survival (RFS). Propensity score matching (PSM) was used to balance the bias. Both OS and RFS were worse in SLT group than in PLT group, especially for those patients within Milan criteria. Our study demonstrates that SLT bears higher risk of recurrence and death than PLT, indicating that SLT should be given a more careful thought at performance.

show abstract

“…Several previous studies indicated that a resection margin of more than 1cm is an independent factor of improved recurrence-free survival[39-42]. But whether it can benefit all HCC patients is still controversial[43-47]. The clinical definition of centrally located HCC emphasizes the vicinity of liver tumor with major vascular structures.…”

Section: Surgical Determination and Resection Marginmentioning

confidence: 99%

Management of centrally located hepatocellular carcinoma: Update 2016

Rao

et al. 2017

WJH

View full text Add to dashboard Cite

Centrally located hepatocellular carcinoma (HCC) is sited in the central part of the liver and adjacent to main hepatic vascular structures. This special location is associated with an increase in the difficulty of surgery, aggregation of the recurrence disease, and greater challenge in disease management. This review summarizes the evolution of our understanding for centrally located HCC and discusses the development of treatment strategies, surgical approaches and recurrence prevention methods. To improve patient survival, a multi-disciplinary modality is greatly needed throughout the whole treatment period.

show abstract

The importance of surgical margins in primary malignancies of the liver

Cited by 53 publications

References 82 publications

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

Salvage Liver Transplantation Leads to Poorer Outcome in Hepatocellular Carcinoma Compared with Primary Liver Transplantation

Management of centrally located hepatocellular carcinoma: Update 2016

Contact Info

Product

Resources

About