World Journal of Surgery

, Volume 42, Issue 5, pp 1514–1522 | Cite as

The Clinical Implications of Liver Resection Margin Size in Patients with Hepatocellular Carcinoma in Terms of Positron Emission Tomography Positivity

  • Jae Hyun Park
  • Dong Hwi Kim
  • Sung Hoon Kim
  • Moon Young Kim
  • Soon Koo Baik
  • In Su Hong
Original Scientific Report

Abstract

Background

The positivity of positron emission tomography (PET) in hepatocellular carcinoma (HCC) correlates with aggressive tumor factors and poor survival. Adequate resection margin size is still a topic of debate. We analyzed the clinical implications of resection margin size in patients with HCC in terms of PET positivity.

Methods

We retrospectively reviewed the medical records of 92 patients who underwent liver resection from March 2012 to October 2015. We investigated prognostic factors for recurrence and survival. We analyzed the correlation of resection margin size and PET positivity. Resection margins were classified as less than 1 cm and more than 1 cm.

Results

Twenty six (31.3%) patients had PET-positive HCC. Multivariate analysis showed PET, satellite nodules, microvessel invasion, and multicentric occurrence were significant prognostic factors for HCC recurrence. Multivariate analysis also showed satellite nodules and microscopic portal vein invasion were significant prognostic factors for overall survival (OS). Resection margin size did not affect disease-free survival (DFS) (p = 0.681) or OS (p = 0.301) in patients with PET-negative HCC, but showed a difference in DFS [<1 cm at 11 months vs. ≥1 cm at 41 months (p = 0.188)] and OS [<1 cm at 28 months vs. ≥1 cm at 48 months (p < 0.001)] in patients with PET-positive HCC.

Conclusions

PET has low sensitivity for HCC. However, it is useful to predict treatment outcomes after liver resection or liver transplantation for HCC. Although the extent of liver resection must be decided based on liver function, a resection margin size >1 cm may improve DFS and OS in patients with PET-positive HCC.

Notes

Acknowledgements

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning (2014R1A1A1007901).

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Jae Hyun Park
    • 1
  • Dong Hwi Kim
    • 1
  • Sung Hoon Kim
    • 1
  • Moon Young Kim
    • 2
  • Soon Koo Baik
    • 2
  • In Su Hong
    • 3
  1. 1.Department of Surgery, Wonju Severance Christian HospitalYonsei University Wonju College of MedicineWonjuKorea
  2. 2.Department of Internal medicine, Wonju Severance Christian HospitalYonsei University Wonju College of MedicineWonjuKorea
  3. 3.Department of Radiology, Wonju Severance Christian HospitalYonsei University Wonju College of MedicineWonjuKorea

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