The Significance of Resection Range and Surgical Margin for Hepatocellular Carcinomas

Kazutaka Furukawa, Eizo Okamoto, Naoki Yamanaka, Tsuyoshi Oriyama, Tsuneo Tanaka, Jiro Fujimoto, Eisuke Kawamura, Nobutaka Ichikawa, Wataru Tanaka, Tomoaki Yasui, Tatsuya Ando, Yoichi Kuroda

First Department of Surgery, Hyogo College of Medicine

The present study reports the significance of the resection range and surgical margin for hepatocellular carcinomas (HCC) based on the experience of 2I7 curative resection cases from 1981 through December 1992. In tumors less than 5 cm in size, the disease-free survival rate of lobectomy was much better than subsegmental or less extensive resection. When the prognosis was compared by surgical margin (SM), those with a SM of more than 20 mm showed a disease-free survival rate much better than shorter SM cases. In selected patients with segmental or less extensive resection of tumors less than 5 cm in size, the most frequent site of recurrence was the same subsegment or one adjacent subsegment to the site of the primary tumor. The incidence of recurrence at SM decreased with wider SM. These findings suggested that hepatectomy should obtain a wider surgical margin and a wider extent of resection. Twelve cases (40%) of 30 disease-free 5-year survivors had subsegmental or less extensive resection. Those patients'tumors were characterized by small size (≤5 cm), single nodule and diploidy. This suggest aht if the HCC is a lower biological grade of malignancy and small, a limited operation may be indicated.

Key words
hepatocellular carcinoma, hepatic resection, extent of resection, surgical margin, recurrence

Reprint requests
Kazutaka Furukawa First Department of Surgery, Hyogo College of Medicine
1-1 Mukogawacho, Nishinomiya, 663 JAPAN

Accepted
July 6, 1994

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