title: Minimum resection margin should be based on tumor size in hepatectomy for hepatocellular carcinoma in hepatoviral infection patients.
abstract: OBJECTIVE
  In patients with hepatoviral infection, although a wide resection margin can eradicate the microsatellite lesions around hepatocellular carcinoma (HCC), a large-volume hepatectomy may diminish remaining liver function and become an obstacle for treating recurrent HCC. The optimal width of the resection margin for these patients is still controversial. This study was conducted to investigate the optimal resection margin in hepatectomy for hepatoviral infection patients.
  
  
  METHODS
  We retrospectively investigated the influences of the resection margin status on recurrence patterns and long-term prognosis in a group of 311 HCC patients with hepatoviral infection who had a solitary HCC without perioperative anti-HCC treatment.
  
  
  RESULTS
  The resection margin status did not statistically influence the postoperative recurrence-free and overall survival rates (3-year recurrence-free survival of 61.0% vs 55.1%, P = 0.33; 5-year overall survival of 74.9% vs 81.5%, P = 0.77 in without a margin vs with a margin, respectively), although resection without a margin increased the local recurrence with marginal significance (P = 0.055). Regarding the width of the resection margin, in 30-mm or smaller HCC, resection margin did not significantly improve the prognosis among hepatoviral infection patients. However, for tumors larger than 30 mm, a resection margin wider than 3 mm showed significant impacts on the prevention of recurrence in spite of the influence of multicentric carcinogenesis.
  
  
  CONCLUSIONS
  The resection margin used for eradication of microsatellite lesions showed differences that were dependent on tumor size in hepatoviral infection patients. Resection margin should be based on not only background liver function but also tumor characteristics.
authors: Department of Digestive Surgery, Hepato Pancreato Biliary Surgery Unit, Toranomon Hospital, Tokyo, Japan.
authors: Kazunari
authors: K
authors: Sasaki
authors: Masamichi
authors: M
authors: Matsuda
authors: Yu
authors: Y
authors: Ohkura
authors: Yusuke
authors: Y
authors: Kawamura
authors: Masaji
authors: M
authors: Hashimoto
authors: Kenji
authors: K
authors: Ikeda
authors: Hiromitsu
authors: H
authors: Kumada
authors: Goro
authors: G
authors: Watanabe
keywords: hepatectomy; hepatocellular carcinoma; resection margin; retrospective analysis