A wide-margin liver resection improves long-term outcomes for patients with HBV-related hepatocellular carcinoma with microvascular invasion

Background The impact of the resection margin on survival outcomes in patients with hepatocellular carcinoma remains to be determined. This study aimed to examine the association between the width of resection margin and the presence of microvascular invasion in hepatitis B virus–related hepatocellular carcinoma. Methods We reviewed data on 2,508 consecutive patients who underwent liver resection for a solitary, hepatitis B virus–related hepatocellular carcinoma for operative morbidity, tumor recurrence, and overall survival. Results Microvascular invasion was identified histologically in 929 patients (37.0%). A wide margin of resection (≥1 cm, n  = 384) resulted in better 5-year recurrence and overall survival versus a narrow margin of resection ( n  = 545) among patients with microvascular invasion (71.1% versus 85.9%; 44.9% versus 25.0%; both P P  = .131, .182). Similar results were identified after propensity-score matching. A wide margin resection also had a lesser incidence of early recurrence developed within the first postoperative 24 months (58.1% versus 72.7%; P P  = .017; 3.5% versus 1.6%; P  = .147) among cirrhotic patients with microvascular invasion. Conclusion The presence of microvascular invasion was associated with a worse prognosis after resection. A wide resection margin resulted in better long-term prognoses versus a narrow resection margin among patients with hepatitis B virus–related hepatocellular carcinoma with microvascular invasion.