title: Is less than 5 mm as the narrowest surgical margin width in central resections of hepatocellular carcinoma justified?
abstract: BACKGROUND
  The aim of this study was to investigate whether <5 mm as the narrowest margin width may negatively affect a patient's outcome.
  
  
  METHODS
  A prospective cohort study was designed. From January 1994 to July 2010, 196 patients with hepatocellular carcinoma undergoing central hepatectomy were divided into group A (n = 172; narrowest margin, ≥5 to <10 mm) and group B (n = 24; narrowest margin, <5 mm), and outcomes were compared.
  
  
  RESULTS
  Significant differences between groups A and B included tumor size (P = .057), infiltrative border (P = .021), satellite lesions (P = .021), and major perivascular abutment (P = .028). Marginal recurrence occurred in 50% of the patients in group B but none of those in group A (P < .001). There were no significant differences between the groups regarding recurrence, recurrence-related death, disease-free survival, and speed of recurrence, but a borderline significant difference was found regarding the cumulative probability of overall survival. After excluding early recurrence (within 1 year), group B had significantly lower cumulative probabilities of disease-free survival (P = .020) and overall survival (P < .001).
  
  
  CONCLUSIONS
  In central resections, narrowest margin width of <5 mm does not negatively affect recurrence and overall survival. However, it increases perimargin recurrence and inversely affects late outcomes.
authors: Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors: Kuo-Shyang
authors: KS
authors: Jeng
authors: Wen-Juei
authors: WJ
authors: Jeng
authors: I-Shyan
authors: IS
authors: Sheen
authors: Chien-Chu
authors: CC
authors: Lin
authors: Cheng-Kuan
authors: CK
authors: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000592:standards*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome