The impact of resection margin and microvascular invasion on long-term prognosis after curative resection of hepatocellular carcinoma: a multi-institutional study
单位:[1]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 20438, Peoples R China[2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Hepat Surg Ctr, Wuhan, Hubei, Peoples R China外科学系肝脏外科华中科技大学同济医学院附属同济医院[3]Chinese Univ Hong Kong, Prince Wales Hosp, Fac Med, Shatin, Hong Kong, Peoples R China[4]Puer Peoples Hosp, Dept Hepatobiliary Surg, Puer, Yunnan, Peoples R China[5]Fourth Hosp Harbin, Dept Gen Surg 1, Harbin, Heilongjiang, Peoples R China[6]Liuyang Peoples Hosp, Dept Gen Surg, Liuyang City, Hunan, Peoples R China[7]Ziyang First Peoples Hosp, Dept Gen Surg, Jianyang, Sichuan, Peoples R China[8]Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Hepatobiliary Surg, Fuzhou, Fujian, Peoples R China
Background: The resection margin (RM) status and microscopic vascular invasion (MVI) are known prognostic factors for hepatocellular carcinoma (HCC). An enhanced understanding of their impact on long-term prognosis is required to improve oncological outcomes. Methods: Using multi-institutional data, the different impact of the RM status (narrow, <1 cm, or wide, >= 1 cm) and MVI (positive or negative) on overall survival (OS) and recurrence-free survival (RFS) after curative liver resection of solitary HCC without macrovascular invasion was analyzed. Results: In 801 patients, 306 (38%) had a narrow RM and 352 (44%) had positive MVI. The median OS and RFS were 109.8 and 74.8 months in patients with wide RM & negative MVI, 93.5 and 53.1 months with wide RM & positive MVI, 79.2 and 41.6 months with narrow RM & negative MVI, and 69.2 and 37.5 months with narrow RM & positive MVI (both P < 0.01). On multivariable analyses, narrow RM & positive MVI had the highest hazard ratio with reduced OS and RFS (HR 2.96, 95% CI 2.11-4.17, and HR 3.15, 95% CI, 2.09-4.67, respectively). Conclusions: Concomitant having narrow RM and positive MVI increases the risks of postoperative death and recurrence by about 2-fold in patients with solitary HCC.
基金:
National Natural Science Foundation of China [81472284, 81672699]; Shanghai Pujiang Program [16PJD004]
第一作者单位:[1]Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg, 225 Changhai Rd, Shanghai 20438, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Han Jun,Li Zhen-Li,Xing Hao,et al.The impact of resection margin and microvascular invasion on long-term prognosis after curative resection of hepatocellular carcinoma: a multi-institutional study[J].HPB.2019,21(8):962-971.doi:10.1016/j.hpb.2018.11.005.
APA:
Han, Jun,Li, Zhen-Li,Xing, Hao,Wu, Han,Zhu, Peng...&Yang, Tian.(2019).The impact of resection margin and microvascular invasion on long-term prognosis after curative resection of hepatocellular carcinoma: a multi-institutional study.HPB,21,(8)
MLA:
Han, Jun,et al."The impact of resection margin and microvascular invasion on long-term prognosis after curative resection of hepatocellular carcinoma: a multi-institutional study".HPB 21..8(2019):962-971