Presentation Description
Institution: Royal Perth Hospital - Western Australia, Australia
Purpose
There is much debate regarding the acceptable surgical margin for HCC resection. emerging evidence suggests that narrower margins and even R1 resections provide comparable oncological results for resection of HCC. We seek to compare survival outcomes following liver resection for HCC between patient based on their margin status.
Methodology
This retrospective cohort study examines patients that underwent primary liver resection for HCC in a tertiary referral centre in Western Australia between 2010 and 2025. Variables were analysed by plotting Kaplan-Meier survival curves, univariate analysis using Cox regression and by creating multivariate Cox models to identify independent predictors of survival.
Results
107 patients underwent liver resection for HCC during the study period. 89 (83.18%), 12(11.21%) and 6 (5.61%) patients had R0, R1 and R2 resections respectively. 61 (57.01%) of patients were cirrhotic. 23 (21.29%) of patients underwent a major hepatectomy. 45 (42.06%) patients had recurrence of HCC during the period of study. 36 (33.64%) patients died during the period of the study. Multivariate analysis demonstrated that patients experiencing an R2 resection have significantly decreased disease free survival (HR: 2.90, CI: 1.14 – 7.41, p: 0.026) and overall survival (HR: 3.34, CI: 1.15 – 9.70, p: 0.027). There was no difference in disease free or overall survival between patients with R0 and R1 resections. Cirrhosis, BCLC stage and patients undergoing a major resection were not found to be significant predictors of survival.
Conclusion
Patients that experience R2 resections have a significantly poorer survival following HCC resection. We identified no difference in outcome when comparing R0 to R1 resections. Acceptance of R1 resections as a reasonable surgical outcome could enable a parenchymal sparing approach in HCC resection and allow patients with borderline remnant liver volume to access potentially curative resection.
Presenters
Authors
Authors
Dr Patrick Walker - , Dr Jessica O'Sullivan - , Dr Suresh Navadgi -
