Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

Background: The relationship between resection margin (RM) and recurrence of resected hepatocellular carcinoma (HCC) is unclear. Methods: We reviewed clinical data for 419 patients with HCC. The oncologic outcomes were compared between 2 groups of patients classified according to the inflexion point of the restricted cubic spline plot. Results: The patients were divided according to an RM of <1 cm (n = 233; narrow RM group) or >= 1 cm (n = 186; wide RM group). The 5-year recurrence-free survival (RFS) rate was lower (34.8 vs. 43.8%, p = 0.042) and recurrence near the resection site was more frequent (4.7 vs. 0%, p= 0.010) in the narrow RM group. Patients with multiple lesions, or prior transarterial chemo-embolization (TACE) or radiofrequency ablation (RFA) were excluded from subgroup analyses. In patients with a 2-5 cm HCC, the 5-year RFS was greater in the wide RM group (54.4 vs. 32.5%, p = 0.036). Narrow RM (hazard ratio 1.750, 95% CI 1.029-2.976, p = 0.039) was independently associated with disease recurrence. Conclusion: In patients with a single 2-5 cm HCC without prior TACE/RFA, an RM of >= 1 cm was associated with lower risk of recurrence after liver resection. (C) 2018 S. Karger AG, Basel