Impact of microscopically positive resection margins (R1) on overall survival and recurrence rate in hepatoblastoma: A systematic review and meta-analysis

This meta-analysis suggests that R1 resection margins are not associated with significantly worse OS or EFS compared with R0 resections in hepatoblastoma. However, R0 resection should remain the surgical objective. In selected, e.g. locally advanced cases, minimal margins may be acceptable when vascular replacement or transplantation can be avoided, as current evidence suggests no significant adverse oncologic impact after neoadjuvant chemotherapy. Nevertheless, existing data are limited to retrospective cohorts, underscoring the need for prospective, histopathologically detailed studies.