Evidence map›Paper›PMID 37432523›Full record

ArticleAnnals of surgical oncology2023

Impact of Surgical Margin Width on Prognosis Following Resection of Hepatocellular Carcinoma Varies on the Basis of Preoperative Alpha-Feto Protein and Tumor Burden Score.

Yutaka Endo, Muhammad Musaab Munir, Selamawit Woldesenbet, Erryk Katayama, Francesca Ratti, Hugo P Marques, François Cauchy, Vincent Lam, George A Poultsides, Minoru Kitago and 11 more

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Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Yutaka EndoDepartment of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Muhammad Musaab MunirDepartment of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Selamawit WoldesenbetDepartment of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Erryk KatayamaDepartment of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Francesca RattiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
François CauchyDepartment of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France.
Vincent LamDepartment of Surgery, Westmead Hospital, Sydney, NSW, Australia.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Sorin AlexandrescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Guillaume MartelDepartment of Surgery, University of Ottawa, Ottawa, ON, Canada.
Aklile WorknehDepartment of Surgery, University of Ottawa, Ottawa, ON, Canada.
Alfredo GuglielmiDepartment of Surgery, University of Verona, Verona, Italy.
Ana GleisnerDepartment of Surgery, University of Colorado, Denver, CO, USA.
Tom HughDepartment of Surgery, School of Medicine, The University of Sydney, Sydney, NSW, Australia.
Luca AldrighettiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Feng ShenDepartment of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Itaru EndoYokohama City University School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA. Tim.Pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to examine the prognostic impact of margin width at time of hepatocellular carcinoma (HCC) resection relative to the alpha-feto protein tumor burden score (ATS). PATIENTS AND

methodsPatients who underwent curative-intent hepatectomy for HCC between 2000 and 2020 were identified from a multi-institutional database. The impact of margin width on overall survival and recurrence-free survival was examined relative to ATS using univariable and multivariable analyses.

resultsAmong 782 patients with HCC who underwent resection, median ATS was 6.5 [interquartile range (IQR) 4.3-10.2]. Most patients underwent R0 resection (n = 613, 78.4%); among patients who had an R0 resection, 325 (41.6%) had a margin width > 5 mm while 288 (36.8%) had a 0-5 mm margin width. Among patients with high ATS, an increasing margin width was associated with incrementally better overall and recurrence-free survival. In contrast, among patients with low ATS, margin width was not associated with long-term outcomes. On multivariable Cox regression analysis, each unit increase in ATS was independently associated with a 7% higher risk of death [hazard ratio (HR) 1.07; 95% confidence interval (CI) 1.03-1.11, p < 0.001]. While the incidence of early recurrence was not associated with margin width among patients with low ATS, wider margin width was associated with an incrementally lower incidence of early recurrence among patients with high ATS.

conclusionATS, an easy-to-use composite tumor-related metric, was able to risk stratify patients following resection of HCC relative to overall survival and recurrence-free survival. The therapeutic impact of resection margin width had a variable impact on long-term outcomes relative to ATS.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsHepatectomyHumansMargins of ExcisionNeoplasm Recurrence, LocalPrognosisRetrospective StudiesTumor BurdenAlpha-feto proteinHepatocellular carcinomaMargin widthMulti-institutional databaseTumor burden

Identifiers

PMID37432523

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.