Detailed Abstract
[Liver Oral Presentation 1 - Liver Disease/Surgery]
[LV OP 1-3] The adequate resection margin of hepatocellular carcinoma according to the tumor microenvironment
Sung Hoon KIM1, Yun Tae KIM4, Joon Hyung SOHN5, Mee-Yon CHO2, Moon Young KIM3, Soon Koo BAIK3
1Department of Surgery, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Korea
2Department of Pathology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Korea
3Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Korea
4Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Korea
5Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Korea, Korea
Introduction : There is no consensus on the safe resection margin in patients with hepatocellular carcinoma (HCC). We investigated the change of tumor microenvironment according to the resection margin.
Methods : We prospectively collected the specimen of 60 patients with HCC. We selected three portions of specimens as follows: tumor, 1cm and 2cm margin normal tissue. We investigated the expression status of tumor microenvironment genes. We compared the expression status according to recurrence, HCC gross type and positron emission tomography (PET) positivity. We divided the patients into two groupsas follows: group 1 included expanding and vaguely nodular types whereas group 2 included nodular with perinodular extension, multinodular confluent and infiltrative types.
Results : Group 2 had a higher prevalence of PET positive [6 (37.5%) vs 10 (62.5%)] and recurrence [5 (16.7%) vs 17 (56.7%)]. However, in cases with more than 1cm resection margin, there was no difference of recurrence rate [9 (75%), p=0.017 vs 8 (44.4%), p=0.06]. Beta-catenin was significantly decreased and E-cadherin was significantly increased according to the resection margin in group 1. Group 2 and PET positive patients showed Group 1 did not show any significant change of beta-catenin and E-cadherin until 2cm resection margin.
Conclusions : Our data suggest that patients with HCC of expanding and vaguely nodular gross types may safely undergo surgical resection with a narrow resection margin and patients with HCC of nodular with perinodular extension, multinodular confluent and infiltrative gross type must undergo surgical resection with more than 2cm resection margin because of tumor microenvironment condition.
Methods : We prospectively collected the specimen of 60 patients with HCC. We selected three portions of specimens as follows: tumor, 1cm and 2cm margin normal tissue. We investigated the expression status of tumor microenvironment genes. We compared the expression status according to recurrence, HCC gross type and positron emission tomography (PET) positivity. We divided the patients into two groupsas follows: group 1 included expanding and vaguely nodular types whereas group 2 included nodular with perinodular extension, multinodular confluent and infiltrative types.
Results : Group 2 had a higher prevalence of PET positive [6 (37.5%) vs 10 (62.5%)] and recurrence [5 (16.7%) vs 17 (56.7%)]. However, in cases with more than 1cm resection margin, there was no difference of recurrence rate [9 (75%), p=0.017 vs 8 (44.4%), p=0.06]. Beta-catenin was significantly decreased and E-cadherin was significantly increased according to the resection margin in group 1. Group 2 and PET positive patients showed Group 1 did not show any significant change of beta-catenin and E-cadherin until 2cm resection margin.
Conclusions : Our data suggest that patients with HCC of expanding and vaguely nodular gross types may safely undergo surgical resection with a narrow resection margin and patients with HCC of nodular with perinodular extension, multinodular confluent and infiltrative gross type must undergo surgical resection with more than 2cm resection margin because of tumor microenvironment condition.
SESSION
Liver Oral Presentation 1
Room C 3/30/2018 9:00 AM - 9:50 AM