Background:The optimal width of resection margin(RM)for hepatocellular carcinoma(HCC)remains controversial.This study aimed to investigate the value of imaging tumor capsule(ITC)and imaging tu-mor size(ITS)in guiding RM width for patients with HCC.Methods:Patients who underwent hepatectomy for HCC in our center were retrospectively reviewed.ITC(complete/incomplete)and ITS(≤3 cm/＞3 cm)were assessed by preoperative magnetic resonance imaging(MRI).Using subgroup analyses based on ITC and ITS,the impact of RM width[narrow RM(＜5 mm)/wide RM(≥5 mm)]on recurrence-free survival(RFS),overall survival(OS),and RM recurrence was analyzed.Results:A total of 247 patients with solitary HCC were included.ITC and ITS were independent predictors for RFS and OS in the entire cohort.In patients with ITS≤3 cm,neither ITC nor RM width showed a significant impact on prognosis,and the incidence of RM recurrence was comparable between the narrow RM and wide RM groups(15.6％vs.4.3％,P=0.337).In patients with ITS＞3 cm and complete ITC,the narrow RM group exhibited comparable RFS,OS,and incidence of RM recurrence with the wide RM group(P=0.606,0.916,and 0.649,respectively).However,in patients with ITS＞3 cm and incomplete ITC,the wide RM group showed better RFS and OS and a lower incidence of RM recurrence compared with the narrow RM group(P=0.037,0.018,and 0.046,respectively).Conclusions:As MRI-based preoperative markers,conjoint analysis of ITC with ITS aids in determining RM width for solitary HCC patients.Narrow RM is applicable in patients with ITS≤3 cm regardless of ITC status and in those with ITS＞3 cm and complete ITC.Wide RM is preferred in those with ITS＞3 cm and incomplete ITC.

Department of General Surgery,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China;Department of Radiology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China;Department of Colorectal Surgery,Fudan University Shanghai Cancer Center,Shanghai 200032,China

[1]Jia-Shuo Chao;Qi Zhu;De-Sheng Chen;Gui-Ming Chen;Xue-Qian Xie;Ai-Qun Liu;Sen-Lin Zhao;Hong-Cheng Sun-.Combined analysis of imaging tumor capsule with imaging tumor size guides the width of resection margin for solitary hepatocellular carcinoma)[J].国际肝胆胰疾病杂志(英文版),2022(06):551-558

Combined,analysis,imaging,tumor,capsule,size,guides,width,resection,margin,solitary,hepatocellular,carcinoma,Background,optimal,RM,HCC,remains,controversial,This,study,aimed,investigate,value,ITC,ITS,guiding,patients,Methods,Patients,who,underwent,hepatectomy,our,center,were,retrospectively,reviewed,incomplete,assessed,by,preoperative,magnetic,resonance,Using,subgroup,analyses,impact,narrow,wide,recurrence,free,survival,RFS,overall,OS,was,analyzed,Results,total,included,independent,predictors,entire,cohort,In,neither,nor,showed,significant,prognosis,incidence,comparable,between,groups,exhibited,respectively,However,better,lower,compared,Conclusions,markers,conjoint,aids,determining,Narrow,applicable,regardless,status,those,Wide,preferred

0.388512