ArticleBMC surgery2026
Neoadjuvant or conversion therapy nullifies the prognostic impact of surgical margin width in hepatocellular carcinoma: a single-center retrospective study.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prognostic role of surgical margin width in hepatocellular carcinoma (HCC) patients undergoing hepatectomy after neoadjuvant or conversion therapy remains unclear. MATERIALS AND
methodsWe retrospectively analyzed 129 HCC patients undergoing hepatectomy following neoadjuvant or conversion therapy and 720 treated with upfront surgery between 2019 and 2022. Propensity score matching (PSM) balances baseline characteristics. Disease-free survival (DFS) was evaluated by Kaplan-Meier analysis, and prognostic factors were assessed via Cox regression.
resultsAmong patients receiving neoadjuvant or conversion therapy, DFS did not differ between wide (≥ 1 cm) and narrow (< 1 cm) margin groups (P = 0.572). Independent predictors of inferior DFS included CNLC-IIb stage (HR = 5.239; 95% CI:1.264–21.717), microvascular invasion (MVI; HR = 2.473; 95% CI:1.050–5.821), and postoperative interventional therapy (HR = 2.914; 95% CI:1.342–6.325), while elevated BMI was protective (HR = 0.87; 95% CI:0.763–0.993). Notably, for narrow-margin patients, DFS was significantly prolonged in the neoadjuvant or conversion cohort versus upfront surgery, both pre-PSM (P = 0.014) and post-PSM (P = 0.019). This benefit was absent in wide-margin patients.
conclusionMargin width may not influence DFS in HCC patients after neoadjuvant or conversion therapy. Excessively wide margins may be unnecessary, allowing surgeons to prioritize parenchymal preservation without compromising outcomes.
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