간경변이 동반된 간세포암에서 근치적 절제후 절제연이 재발양상에 미치는 영향
Effects of Surgical Margin on the Recurrence after Curative Resection for Hepatocellular Carcinoma associated with Cirrhosis
대한암학회지 1993년 25권 4호 p.488 ~ 493
유무영, 이건욱, 김수태,
소속 상세정보
유무영 ( )
서울대학교
이건욱 ( )
서울대학교
김수태 ( )
서울대학교
KMID : 0360319930250040488
Abstract
We studied to elucidate whether surgical margin is related to recurrence after curative resection of hepatocellular carcinoma in patient with cirrhosis. Forty patients who underwent curative hepatic resection for hepatocellular carcinoma with
cirrhosis
between Jan 1988 and Dec 1989 and met the following criteria(histologically preven cirrhosis, solitary nodule less than 10 cm, resection less than formal segmentectomy, no evidence of direct invasion or metastasis) were included in this study.
Resection
margin was expressed as RM0 and RM1 when resection margin is less than 1 cm and equal to or greater than 1 cm respectively. There was o statistical difference in the recurrence free rate curve between RM0(N=25) and RM1(n=15). In patients with
tumor
size
equal to or greater than 4 cm, there was no statistical difference in the recurrence free rate curve between RM0(n=12) and RM1(n=5). But in patients with tumor size less than 4 cm, there was significant difference between RM0(n=13) and RM1(n=10).
In conclusion, in case of small hepatocellular carcinoma, we can reduce the intraheptic recurrence rate with larger resection margin as long as liver reserve function is permitted. But in large hepatocellular carcinoma, recurrence cannot be
reduced
with
large resection margin, so another therapeutic modality may be necessary.
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