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Prognostic Impact of Surgical Margins for Hepatocellular Carcinoma According to Preoperative Alpha-Fetoprotein Level.

Abstract : BACKGROUND: HCC are known to have satellite nodules and microvascular invasions requiring sufficient margins. An alpha-fetoprotein (AFP) level >100 ng/mL is associated with worse pathological features in HCC. In practice, large resection margins, particularly >1~cm, are infrequently retrieved on the specimens. METHODS: 397 patients from 5 centres were included from 2012 to 2017. The primary endpoint was time-to-recurrence in relation to AFP level (> or <100 ng/ml) as well as surgical margins (> or <1 cm). The secondary endpoint was overall survival (OS). RESULTS: The median follow-up was 25 months. In Low AFP group, median time to recurrence (TTR) for patients with margins <1 cm was 36 months and for patients with margins ≥q1 cm was 34 months (p = 0.756), and overall survival (OS) was not significantly different according to margins (p = 0.079). In High-AFP group, patients with margins <1 cm had a higher recurrence rate than patients with margins ≥q1 cm (p = 0.016): median TTR for patients with margins <1 cm was 8 months whereas it was not reached for patients with margins ≥q1 cm. Patients with margins <1 cm had a significantly worse OS compared to the patients with margins ≥q1 cm (p = 0.043). CONCLUSION: Preoperative AFP level may help determine margins to effectively treat high AFP tumours. For low-AFP tumours, margins didn't have an impact on TTR or OS.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03692960
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Soumis le : vendredi 10 juin 2022 - 10:32:37
Dernière modification le : mardi 22 novembre 2022 - 14:26:16

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Frédéric Marques, Mohammed Ghallab, Eric Vibert, Emmanuel Boleslawski, Olivier Soubrane, et al.. Prognostic Impact of Surgical Margins for Hepatocellular Carcinoma According to Preoperative Alpha-Fetoprotein Level.. HPB, 2022, 24 (6), pp.848--856. ⟨10.1016/j.hpb.2021.10.012⟩. ⟨hal-03692960⟩

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