The Prognostic Significance of Surgical Margin in Liver Resection of Patients With Hepatocellular Carcinoma

Seizo Masutani, MD; Yo Sasaki, MD; Shingi Imaoka, MD; Shinichi Iwamoto, MD; Ichiro Ohashi, MD; Masao Kameyama, MD; Toshiyuki Kabuto, MD; Osamu Ishikawa, MD; Hiroshi Furukawa, MD; Hiroki Koyama, MD; Takeshi Iwanaga, MD
Arch Surg. 1994;129(10):1025-1030. doi:10.1001/archsurg.1994.01420340039007.
Text Size: A A A
Published online

Objective:  To evaluate the prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

Design:  Retrospective study.

Setting:  The Center for Adult Diseases, Osaka, Japan, between 1980 and 1989.

Patients:  One hundred eighty-five patients with hepatocellular carcinoma who underwent liver resection with complete extirpation.

Main Outcome Measure:  Cumulative survival rate.

Results:  The patients were divided into a wide surgical margin group, in which the lesion was excised with a margin of 1.0 cm or more, and a narrow surgical margin group, in which the margin was less than 1.0 cm. No significant differences could be detected in survival rates for 3 years or longer. Mean±SE tumor sizes were 3.4±0.4 cm and 4.4±0.3 cm, respectively, in the wide and narrow surgical margin groups. The patients were divided into three groups according to tumor size: group 1, 2.0 cm or less in diameter; group 2, greater than 2.0 cm but 5.0 cm or less in diameter; and group 3, greater than 5.0 cm in diameter. In groups 2 and 3, no significant differences in survival rates were found between the wide and narrow surgical margin groups. In group 1, the survival rate was significantly higher in the wide surgical margin group than in the narrow surgical margin group (P<.05).

Conclusions:  Small hepatocellular carcinomas of 2.0 cm or less in diameter should be resected with an adequate surgical margin. However, surgical margin was not a significant factor in the resection of hepatocellular carcinomas larger than 2.0 cm.(Arch Surg. 1994;129:1025-1030)


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.