[Prophylaxis and clinical treatment for surgical margin recurrence of small primary hepatocellular carcinoma].
OBJECTIVE
Along with the advance of medical technology and instruments, many patients with small primary hepatocellular carcinoma (HCC) had been found, who are mainly treated with surgical resection with high postoperative recurrence rate of over 60%. This study was to explore prophylaxis and clinical treatment for these patients to reduce postoperative recurrence rate.


METHODS
Clinicopathologic data of 283 patients with small HCC, treated in Central Hospital of Kaiping and Cancer Center of Sun Yat-sen University from 1991 through May 2003, were analyzed. Over 85% patients suffered cirrhosis with liver reserve dysfunction, and were mainly treated with irregular hepatectomy. Of the 283 patients, 140 received application of anhydrous alcohol injection or alcohol-soaked gelatin sponge on surgical margin (test group), 143 received no application of alcohol on surgical margin (control group). The 2 groups were comparable in age, gender, tumor location, clinical stage, and Child-Pugh stage.


RESULTS
The 1-year surgical margin recurrence rate was significantly higher in test group than in control group (21.4% vs. 4.4%, P0.05). Intrahepatic metastasis or recurrence rate, 5-year overall survival rate, and tumor-free survival rate were not different between the 2 groups. Both groups had no severe complications.


CONCLUSIONS
Application of anhydrous alcohol on surgical margin or anhydrous alcohol injection in remnant liver after irregular hepatectomy may benefit to reduce postoperative recurrence in surgical margin for small PLC, but has no impact on intrahepatic metastases and recurrence in remnant liver.
Fang
Wan-Qiang
WQ
Department of Hepatobiliary Surgery, Central Hospital of Kaiping City, Kaiping, Guangdong, 529300, PR China.
Li
Sheng-Ping
SP
Zhang
Chang-Qing
CQ
Xu
Li
L
Shi
Ming
M
Chen
Min-Shan
MS
Li
Jin-Qing
JQ
D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D012189:Retrospective Studies
D000431:Ethanol