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

Annals of Surgical Oncology
Gaya SpolveratoTimothy M Pawlik

Abstract

The influence of margin status on long-term outcome of patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC) remains controversial. We sought to study the impact of surgical tumor margin status on recurrence-free survival (RFS) and overall survival (OS) of patients undergoing resection for ICC. From a multi-institutional database, 583 patients who underwent hepatic resection for ICC were identified. Demographics data, operative details, pathologic margin status, and long-term outcomes were collected and analyzed. Margin status was positive (R1) in 95 (17.8 %) patients; among patients who underwent an R0 resection (80.9 %), margin width was negative by 1-4 mm in 166 (31.0 %) patients, 5-9 mm in 100 (18.7 %) patients, and ≥1 cm in 174 (32.5 %) patients. Overall, 379 (65.0 %) patients had a recurrence: 61.5 % intrahepatic, 13.5 % extrahepatic, and 25.0 % both intra- and extrahepatic. Median and 5-year RFS and OS was 10.0 months and 9.2 %, and 26.4 months and 23.0 %, respectively. Patients who had an R1 resection had a higher risk of recurrence (hazard ratio [HR] 1.61, 95 % CI 1.15-2.27; p = 0.01) and shorter OS (HR 1.54, 95 % CI 1.12-2.11). Among patients with an R0 resection, margin width was also associat...Continue Reading

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Citations

Apr 23, 2016·Journal of Surgical Oncology·Alessandro VitaleTimothy M Pawlik
Dec 15, 2015·Journal of Surgical Oncology·Kelly LafaroTimothy M Pawlik
Aug 12, 2016·Clinical and Translational Imaging : Reviews in Nuclear Medicine and Molecular Imaging·M N G J A BraatM G E H Lam
Jun 19, 2018·Expert Review of Gastroenterology & Hepatology·Malcolm H SquiresTimothy M Pawlik
Oct 31, 2018·European Journal of Nuclear Medicine and Molecular Imaging·Héloïse BourienJulien Edeline
Jun 7, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Philipp Konstantin HaberMoritz Schmelzle
Aug 25, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Guido FiorentiniLuca Aldrighetti
Sep 27, 2019·Annals of Surgical Oncology·Aslam EjazTimothy M Pawlik
Jul 27, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Xu-Feng ZhangTimothy M Pawlik
Aug 26, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Fabio BaganteTimothy M Pawlik
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May 19, 2020·Annals of Surgical Oncology·Jordan M CloydTimothy M Pawlik
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Jan 6, 2021·Journal of Clinical Medicine·Eliza W BealTimothy M Pawlik
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Feb 4, 2021·Current Problems in Surgery·T Peter KinghamMichael I D'Angelica
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Jun 3, 2021·Journal of Clinical Medicine·Sudha KodaliRafik M Ghobrial
Jul 3, 2021·Journal of Clinical Medicine·Carolin CzaudernaJens U Marquardt

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