BACKGROUND The objective of this study was to investigate the survival outcomes of surgical margin width in intrahepatic cholangiocarcinoma (ICC), and evaluate the efficacy of postoperative adjuvant therapy (p-AT) in ICC patients underwent narrow-margin hepatectomy (NMH).METHODS Between November 2011 and August 2017, patients who underwent hepatectomy for ICC were collected from 13 major hepatopancreatobiliary centers in China. The survival outcomes for patients who underwent wide margin hepatectomy (WMH) were compared with those who underwent NMH using the 1:1 propensity score matching (PSM). For patients who underwent NMH, the relationship between p-AT and overall survival (OS) and disease-free survival (DFS) were analyzed. RESULTS Among 478 included patients, 195(40.8%) underwent WMH whereas 283(59.2%) underwent NMH. PSM yielded 79 matched patients with similar baseline characteristics. Patients underwent WMH had a significant better OS and DFS compared with those underwent NMH (before PSM: Median OS 27 vs. 17 months, P <0.05; Median DFS 15 vs. 8 months, P = 0.001), (after PSM: Median OS 41 vs. 22 months, p <0.05; Median DFS 16 vs. 10 months, p <0.05). However, based on the AJCC staging system, WMH could only improve the survival outcomes in early ICC patients (Stage I: OS, DFS, P <0.05; Stage II: OS, DFS, P >0.05; Stage III: OS, DFS, P >0.05). For patient underwent NMH, p-AT following NMH showed a better OS and RFS when compared to those who underwent NMH alone (OS, P = 0.05; DFS, p <0.05). CONCLUSION With the current data, we suggest surgeons should strive to achieve a wide surgical margin for patients with early ICC to optimize the long-term outcome. The effect of p-AT for the outcome of ICC patients underwent NMH need to be explored further.
Postoperative adjuvant therapy following radical resection for intrahepatic cholangiocarcinoma: A multicenter retrospective study
