Prognosis and Circumferential Margin in Patients with Resected Hilar Cholangiocarcinoma.

Abstract:

BACKGROUND:Resection margin status is a known prognosticator in patients who undergo resection for hilar cholangiocarcinoma. However, the influence of an isolated positive circumferential margin on clinical outcome is unclear. METHODS:Patients with resected de novo hilar cholangiocarcinoma from two European hepatobiliary centres (Medical University of Vienna and Aintree University Hospital, 2006-2016) were classified according to resection margin status (negative, surgically positive, isolated circumferentially positive) and investigated with respect to overall survival (OS), recurrence-free survival (RFS) and recurrence pattern. RESULTS:Eighty-three (48 male/35 female) patients were enrolled. The median age was 64 years (range 33-80). The median follow-up was 21.7 months (range 0.3-92.4). Forty (48%) patients had negative resection margins, 25 (30%) had an isolated positive circumferential margin and 18 (22%) had a positive surgical margin. The 5-year OS rates in patients with negative, isolated positive circumferential and positive surgical resection margins were 47%, 33% and 0%, respectively. Median OS was 45.6, 32.7 and 14.5 months, respectively (log rank, P = 0.011). Upon multivariable Cox regression analysis, resection margin status and lymph node status remained statistically significant (P < 0.05). No difference with respect to RFS and recurrence pattern was found between the groups (P > 0.05). CONCLUSION:Our data show that these three resection margin types were associated with different clinical outcomes. Circumferential margin status may therefore serve as a novel prognostic biomarker.

journal_name

Ann Surg Oncol

authors

Stremitzer S,Stift J,Laengle J,Schwarz C,Kaczirek K,Jones RP,Quinn LM,Fenwick SW,Diaz-Nieto R,Poston GJ,Malik HZ

doi

10.1245/s10434-020-09105-1

subject

Has Abstract

pub_date

2020-09-10 00:00:00

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-020-09105-1

pub_type

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