J Cancer 2021; 12(15):4455-4462. doi:10.7150/jca.57896

Research Paper

Effect of surgical margin on postoperative prognosis in patients with solitary hepatocellular carcinoma: A propensity score matching analysis

Zewen Zhou1,2, Lunan Qi1, Qiuyan Mo1,2, Yingchun Liu1, Xianguo Zhou1, Zihan Zhou1, Xiumei Liang1, Shixiong Feng1,2, Hongping Yu1,2✉

1. Guangxi Medical University Cancer Hospital, Nanning 530021, China.
2. School of Public Health, Guangxi Medical University, Nanning 530021, China.
Zewen Zhou and Lunan Qi contributed equally to this work.

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Citation:
Zhou Z, Qi L, Mo Q, Liu Y, Zhou X, Zhou Z, Liang X, Feng S, Yu H. Effect of surgical margin on postoperative prognosis in patients with solitary hepatocellular carcinoma: A propensity score matching analysis. J Cancer 2021; 12(15):4455-4462. doi:10.7150/jca.57896. Available from https://www.jcancer.org/v12p4455.htm

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Abstract

Objective: The effect of surgical margin (SM) on the postoperative prognosis of patients with solitary hepatocellular carcinoma (HCC) remains controversial. This study aimed to evaluate the effect of SM on the postoperative prognosis of patients with solitary HCC by using propensity score matching (PSM).

Methods: Patients with solitary HCC who underwent liver resection were divided into a wide margin group (1.0 cm or more, group W) and a narrow margin group (< 1.0 cm, group N). Progression-free survival (PFS) and overall survival (OS) associated with the SM status and the factors influencing postoperative prognosis were evaluated.

Results: Before PSM, the indicators were not balanced between the two groups. PFS and OS were significantly lower in group N than group W. The factors affecting postoperative prognosis were international normalized ratio (INR), AST, capsule integrity, microvascular invasion, tumour embolus and tumour size. After PSM, data of both groups were balanced and comparable, and no significant differences in OS or PFS between the two groups. The INR in the above affecting factors was excluded.

Conclusion: For solitary HCC patients with negative SMs, SM size does not affect prognosis. INR, AST, capsule integrity, microvascular invasion, tumour embolus and tumour size are independent factors influencing the postoperative prognosis of solitary HCC patients.

Keywords: surgical margin, postoperative prognosis, propensity score matching, hepatocellular carcinoma