NDLI: Intrahepatic cholangiocarcinoma – influence of resection margin and tumor distance to the liver capsule on survival

Content Provider	Springer Nature : BioMed Central
Author	Bartsch, Fabian Baumgart, Janine Hoppe-Lotichius, Maria Straub, Beate K. Heinrich, Stefan Lang, Hauke
Abstract	Background Intrahepatic cholangiocarcinoma (ICC) is often diagnosed in advanced stage. Aim of this study was to analyse the influence of resection margins and tumor distance to the liver capsule on survival and recurrence in a single center with a high number of extended resections. Methods From January 2008 to June 2018 data of all patients with ICC were collected and further analysed with Kaplan Meier Model, Cox regression or Chi2 test for categorical data. Results Out of 210 included patients 150 underwent curative intended resection (71.4%). Most patients required extended resections (n = 77; 51.3%). R0-resection was achieved in 131 patients (87.3%) with minimal distances to the resection margin > 1 cm in 22, 0.5-1 cm in 11, 0.1–0.5 cm in 49 patients, and < 0.1 cm in 49 patients. Overall survival (OS) for margins > 0.5 cm compared to 0.5–0.1 cm or R1 was better, but without reaching significance. All three groups had significantly better OS compared to the irresectable group. Recurrence-free survival (RFS) was also better in patients with a margin > 0.5 cm than in the < 0.5–0.1 cm or the R1-group, but even without reaching significance. Different distance to the liver capsule significantly affected OS, but not RFS. Conclusions Wide resection margins (> 0.5 cm) should be targeted but did not show significantly better OS or RFS in a cohort with a high percentage of extended resections (> 50%). Wide margins, narrow margins and even R1 resections showed a significant benefit over the irresectable group. Therefore, extended resections should be performed, even if only narrow margins can be achieved.
Related Links	https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-020-00718-7.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712482
DOI	10.1186/s12893-020-00718-7
Journal	BMC Surgery
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-04-06
Access Restriction	Open
Subject Keyword	Surgery Internal Medicine Intrahepatic cholangiocarcinoma Cholangiocarcinoma Resection margin Tumor distance Liver capsule Overall survival Recurrence
Content Type	Text
Resource Type	Article
Subject	Surgery
Journal Impact Factor	1.6/2023
5-Year Journal Impact Factor	1.9/2023

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