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The significance of resection margins on R0 results in intrahepatic cholangiocarcinoma
B O Stüben1, S Ahmadi1, F H Saner2
1Department of General-, Visceral- and Transplant Surgery, Medical Centre University Duisburg-Essen, 45147, Essen, Germany.
Surgical Oncology
|March 3, 2024
Summary
For intrahepatic cholangiocarcinoma surgery, wider resection margins did not improve survival. Instead, lymph node status, vascular invasion, and non-anatomical resections significantly impact patient outcomes.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Intrahepatic cholangiocarcinoma (ICC) is a primary liver cancer with increasing global incidence.
- Surgical resection offers the only potential cure, but dismal survival rates are linked to recurrence and metastasis.
- The benefit of wide resection margins for ICC recurrence remains debated.
Purpose of the Study:
- To evaluate the impact of resection margin width on recurrence-free and overall survival in patients with ICC.
- To identify prognostic factors influencing oncological outcomes after hepatic resection for ICC.
Main Methods:
- Retrospective analysis of 126 patients who underwent R0 resection for ICC.
- Patients were stratified into three groups based on margin width: <1 mm, 1-5 mm, and >5 mm.
- Univariate analysis and Kaplan-Meier plots were used to assess survival outcomes.
Main Results:
- Wider resection margins (>5 mm) were not significantly associated with improved recurrence-free or overall survival.
- Positive lymph nodes (HR 2.50) and non-anatomic resections (HR 2.06) significantly correlated with poorer overall survival.
- V2 vascular invasion was the sole significant risk factor for poorer recurrence-free survival (HR 8.83).
Conclusions:
- Resection margin width has no significant impact on disease-free or overall survival in ICC hepatic resection.
- Non-anatomical resections, lymph node positivity, and vascular invasion are critical factors affecting oncological outcomes in ICC.
- Focusing on factors beyond margin width may improve surgical strategies for ICC.
