Clinical and Pathological Study of Tumor Border Invasion—Is Narrow Resection Margin Acceptable in Hepatoblastoma Surgery?

Abstract

Aim: We aim to study clinically and pathologically whether narrow resection margin (<1 cm) is acceptable in hepatoblastoma surgery.Methods: A total of 42 patients who underwent surgery for hepatoblastoma were selected, and these patients were divided into two groups according to whether or not they underwent preoperative chemotherapy (CHT). The general characteristics of the patients were summarized, the resection margin distance was recorded, and the event-free survival rates were followed up. Pathologically, H&E staining and immunochemical staining were used to study the invasion distance outside the tumor capsule in the tumor border.Results: Clinically, the event-free survival rates were not significantly different between the patients with wide resection margin (>1 cm) and narrow resection margin (<1 cm) of the two groups. Pathologically, the tumor of all 42 patients had capsules surrounding the tumor. Of the patients in Group 1 (without preoperative CHT), 9% (2/22) had micrometastatic cancer nests outside the capsule, and the farthest distance from the cancer nests to the capsule was 4.6 mm. Of the patients in Group 2 (with preoperative CHT), 75% (15/20) showed residual cancer nests in the paratumor liver tissue, and the farthest distance was 9.6 mm; three and two cases, respectively, showed extracapsular intravascular microtumorous thrombi.Conclusion: Clinically and pathologically, narrow resection margin is acceptable in hepatoblastoma surgery.

Trans-Ancestry Mutation Landscape of Hepatoblastoma Genomes in Children

“…If the tumor cannot be resected in one-stage, we need preoperative chemotherapy. Detailed methods were described in our prior paper (7). Formalinfixed paraffin-embedded (FFPE) samples of tumors and corresponding noncancerous liver tissue were obtained.…”

“…We selected 20 pairs of HB tumors (including 16 cases of sequenced tumors) and paracancerous liver tissues to carry out immunohistochemical (IHC) staining for the proteins expressed by the two genes (b-catenin and KMT2D). The experiment was carried out as described by our previous study (7). The tissues were incubated with antibodies against b-catenin (ab16051, 1:100; Abcam, USA) and KMT2D (ab224156, 1:200, Abcam, USA) for 1 hour at room temperature and then incubated with secondary antibody (Dako); sections were stained with hematoxylin.…”

“…Complete tumor resection is the main method for the treatment of HB. However, many children with HB are ineligible for resection at the initial stage of diagnosis because the tumor volume is too large or the tumor is too close to main blood vessels (7). With the application of platinum-based neoadjuvant chemotherapy, a large number of patients who could not initially undergo surgery have achieved complete tumor resection by reducing the tumor volume before surgery, and the prognosis of children with this disease has been greatly improved (8).…”

Fluorescent Imaging and Multifusion Segmentation for Enhanced Visualization and Delineation of Glioblastomas Margins

“…A major reason is that incompletely resected margins require re-excision, causing additional corporal and psychological encumbrance to the patient. Moreover, the medical expert also takes into consideration the small, yet aggravating possibility of local recurrence in treated patients triggered by miss-detected marginal regions of the tumor during pathological sampling [2]. Therefore, except for tumor detection, it is of paramount importance to trace and further examine the accurate position and structural composition of the cancerous tissue segments so as to facilitate efficient excision, while, in parallel, making certain that, firstly, healthy tissue is not damaged and, secondly, the possibility of cancer recurrence is sufficiently decreased (at least in terms of unsuccessful surgery or surgical failures).…”

“…Hence, for resection of malignant tissue, developing a competent framework for demarcating tumor margins non-invasively could prove extremely beneficial in clinical practice. It may both facilitate efficient removal of cancer via surgical procedures and prevent the disease from occurring again [2,3].…”