scholarly journals Impact of surgical margin width on long-term outcomes for intrahepatic cholangiocarcinoma: a multicenter study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongzhi Liu ◽  
Lianku Lin ◽  
Ziguo Lin ◽  
Yifan Chen ◽  
Qizhen Huang ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Margin ◽  
Staging System ◽  
Survival Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Margin Width ◽  
Ajcc Staging System ◽  
Ajcc Staging

Abstract Background The objective of this study was to investigate the survival outcomes of surgical margin width in intrahepatic cholangiocarcinoma (ICC). 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 narrow margin hepatectomy (NMH) using the 1:1 propensity score matching (PSM). 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, subgroup analysis based on the AJCC staging system, WMH could only improve the survival outcomes in AJCC I ICC patients (Stage I: OS, DFS, P<0.05). Conclusions Surgeons should strive to achieve a wide surgical margin for patients with AJCC I ICC to optimize the long-term outcome.

scholarly journals Impact of Surgical Margin Width and Postoperative Adjuvant Therapy on Long-Term Outcomes for Intrahepatic Cholangiocarcinoma: A Propensity Score Matching Analysis

2020 ◽  
Vol 3 (S1) ◽  
pp. 24-34
Author(s):  
Liu Hongzhi ◽  
◽  
Lin Lianku ◽  
Lin Ziguo ◽  
Chen Yifan ◽  
...  
Keyword(s):  
Propensity Score ◽  
Adjuvant Therapy ◽  
Propensity Score Matching ◽  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Margin ◽  
Survival Outcomes ◽  
Postoperative Adjuvant Therapy ◽  
Long Term Outcome ◽  
Margin Width

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.

The Impact of Surgical Margin Status on Long-Term Outcome After Resection for Intrahepatic Cholangiocarcinoma

2015 ◽  
Vol 22 (12) ◽  
pp. 4020-4028 ◽  
Author(s):  
Gaya Spolverato ◽  
Mohammad Y. Yakoob ◽  
Yuhree Kim ◽  
Sorin Alexandrescu ◽  
Hugo P. Marques ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Margin ◽  
Margin Status ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact

Mo1041 Long-Term Survival Outcomes After Incorporation of Serum Pretreatment AFP Levels Into AJCC Staging System in Hepatocellular Carcinoma

2014 ◽  
Vol 146 (5) ◽  
pp. S-993-S-994
Author(s):  
Sumeet Munjal ◽  
Chetasi Talati ◽  
Pragatheeshwar Thirunavukarasu ◽  
Kristopher Attwood ◽  
Renuka Iyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Staging System ◽  
Survival Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Ajcc Staging System ◽  
Ajcc Staging

scholarly journals Impact of Morphological Status on Long-Term Outcome Among Patients Undergoing Liver Surgery for Intrahepatic Cholangiocarcinoma

2017 ◽  
Vol 24 (9) ◽  
pp. 2491-2501 ◽  
Author(s):  
Fabio Bagante ◽  
Gaya Spolverato ◽  
Matthew Weiss ◽  
Sorin Alexandrescu ◽  
Hugo P. Marques ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Liver Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Morphological Status

scholarly journals Proposal of a New Definition of “Very Early” Intrahepatic Cholangiocarcinoma—A Retrospective Single-Center Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4073
Author(s):  
Oliver Beetz ◽  
Angelica Timrott ◽  
Clara A. Weigle ◽  
Andreas Schroeter ◽  
Sebastian Cammann ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Tumor Biology ◽  
Extrahepatic Disease ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Definition Of

Intrahepatic cholangiocarcinoma (ICC) is a rare disease with poor outcome, despite advances in surgical and non-surgical treatment. Recently, studies have reported a favorable long-term outcome of “very early” ICC (based on tumor size and absence of extrahepatic disease) after hepatic resection and liver transplantation, respectively. However, the prognostic value of tumor size and a reliable definition of early disease remain a matter of debate. Patients undergoing resection of histologically confirmed ICC between February 1996 and January 2021 at our institution were reviewed for postoperative morbidity, mortality, and long-term outcome after being retrospectively assigned to two groups: “very early” (single tumor ≤ 3 cm) and “advanced” ICC (size > 3 cm, multifocality or extrahepatic disease). A total of 297 patients were included, with a median follow-up of 22.8 (0.1–301.7) months. Twenty-one (7.1%) patients underwent resection of “very early” ICC. Despite the small tumor size, major hepatectomies (defined as resection of ≥3 segments) were performed in 14 (66.7%) cases. Histopathological analyses revealed lymph node metastases in 5 (23.8%) patients. Patients displayed excellent postoperative outcome compared to patients with “advanced” disease: intrahospital mortality was not observed, and patients displayed superior long-term survival, with a 5-year survival rate of 58.2% (versus 24.3%) and a median postoperative survival of 62.1 months (versus 25.3 months; p = 0.013). In conclusion, although the concept of a “very early” ICC based solely on tumor size is vague as it does not necessarily reflect an aggressive tumor biology, our proposed definition could serve as a basis for further studies evaluating the efficiency of either surgical resection or liver transplantation for this malignant disease.

scholarly journals Intrahepatic cholangiocarcinoma - Influence of resection margins on long-term outcome

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S399-S400
Author(s):  
F. Bartsch ◽  
J. Baumgart ◽  
M. Hoppe-Lotichius ◽  
B. Straub ◽  
S. Heinrich ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Resection Margins ◽  
Term Outcome ◽  
Long Term Outcome
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