Prognostic value of resection margin length after surgical resection for intrahepatic cholangiocarcinoma.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 29 06 2020
revised: 06 12 2020
accepted: 10 12 2020
pubmed: 4 1 2021
medline: 16 9 2021
entrez: 3 1 2021
Statut: ppublish

Résumé

The definition and prognostic value of a wide resection margin remains controversial. The aim of this study was to assess the relevance of resection margin length for survival following intrahepatic cholangiocarcinoma (ICC) resection. Patients scheduled for curative resection for ICC between 2015 and 2018 were identified from an institutional database. Demographic data, pathological margin length, and oncologic outcomes were collected and analyzed. This study included 126 patients, of whom 78% underwent anatomical hepatectomy. The resection margin was <0.5, <1.0, and <1.5 cm in 73 (60%), 92 (73%), and 109 (87%) patients, respectively. A resection margin ≥1.0 cm was associated with favorable overall survival (OS) (HR: 0.403; 95% CI: 0.191-0.854; P = 0.018) and recurrence-free survival (RFS) (HR: 0.436; 95% CI: 0.232-0.817; P = 0.010). In the anatomical hepatectomy group, a resection margin ≥1.0 cm was an independent predictor of superior OS (HR: 0.451; 95% CI: 0.208-0.977; P = 0.043) and RFS (HR: 0.470; 95% CI: 0.242-0.914; P = 0.026). A resection margin ≥1.0 cm was associated with significantly improved survival in ICC. Therefore, a clear margin of at least 1.0 cm should be achieved during ICC resection.

Sections du résumé

BACKGROUND BACKGROUND
The definition and prognostic value of a wide resection margin remains controversial. The aim of this study was to assess the relevance of resection margin length for survival following intrahepatic cholangiocarcinoma (ICC) resection.
METHODS METHODS
Patients scheduled for curative resection for ICC between 2015 and 2018 were identified from an institutional database. Demographic data, pathological margin length, and oncologic outcomes were collected and analyzed.
RESULTS RESULTS
This study included 126 patients, of whom 78% underwent anatomical hepatectomy. The resection margin was <0.5, <1.0, and <1.5 cm in 73 (60%), 92 (73%), and 109 (87%) patients, respectively. A resection margin ≥1.0 cm was associated with favorable overall survival (OS) (HR: 0.403; 95% CI: 0.191-0.854; P = 0.018) and recurrence-free survival (RFS) (HR: 0.436; 95% CI: 0.232-0.817; P = 0.010). In the anatomical hepatectomy group, a resection margin ≥1.0 cm was an independent predictor of superior OS (HR: 0.451; 95% CI: 0.208-0.977; P = 0.043) and RFS (HR: 0.470; 95% CI: 0.242-0.914; P = 0.026).
CONCLUSIONS CONCLUSIONS
A resection margin ≥1.0 cm was associated with significantly improved survival in ICC. Therefore, a clear margin of at least 1.0 cm should be achieved during ICC resection.

Identifiants

pubmed: 33388133
pii: S0002-9610(20)30800-X
doi: 10.1016/j.amjsurg.2020.12.022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

383-389

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors declared no conflicts of interest.

Auteurs

Hongxu Zhu (H)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Longrong Wang (L)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Miao Wang (M)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Xigan He (X)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Weiqi Xu (W)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Weiping Zhu (W)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Yiming Zhao (Y)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.

Lu Wang (L)

Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China. Electronic address: wanglushanghaicancercenter@hotmail.com.

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Classifications MeSH