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Importance of surgical margin in the outcomes of hepatocholangiocarcinoma

AIM: To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma (HCC-CC). METHODS: Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from 1995 to 2014 were reviewed. Patients with pathologically confirmed HCC-CC we...

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Autores principales: Ma, Ka Wing, Chok, Kenneth Siu Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424293/
https://www.ncbi.nlm.nih.gov/pubmed/28539991
http://dx.doi.org/10.4254/wjh.v9.i13.635
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author Ma, Ka Wing
Chok, Kenneth Siu Ho
author_facet Ma, Ka Wing
Chok, Kenneth Siu Ho
author_sort Ma, Ka Wing
collection PubMed
description AIM: To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma (HCC-CC). METHODS: Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from 1995 to 2014 were reviewed. Patients with pathologically confirmed HCC-CC were included for analysis. Demographic, biochemical, operative and pathological data were analyzed against survival outcomes. RESULTS: Forty-two patients were included for analysis. The median age was 53.5 years. There were 29 males. Hepatitis B virus was identified in 73.8% of the patients. Most patients had preserved liver function. The median preoperative indocyanine green retention rate at 15 min was 10.2%. The median tumor size was 6.5 cm. Major hepatectomy was required in over 70% of the patients. Hepaticojejunostomy was performed in 6 patients. No hospital death occurred. The median hospital stay was 13 d. The median follow-up period was 32 mo. The 5-year disease-free survival and overall survival were 23.6% and 35.4% respectively. Multifocality was the only independent factor associated with disease-free survival [P < 0.001, odds ratio 4, 95% confidence interval (CI): 1.9-8.0]. In patients with multifocal tumor (n = 20), resection margin of ≥ 1 cm was associated with improved 1-year disease-free survival (40% vs 0%; log-rank, P = 0.012). CONCLUSION: HCC-CC is a rare disease with poor prognosis. Resection margin of 1 cm or above was associated with improved survival outcome in patients with multifocal HCC-CC.
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spelling pubmed-54242932017-05-24 Importance of surgical margin in the outcomes of hepatocholangiocarcinoma Ma, Ka Wing Chok, Kenneth Siu Ho World J Hepatol Retrospective Study AIM: To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma (HCC-CC). METHODS: Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from 1995 to 2014 were reviewed. Patients with pathologically confirmed HCC-CC were included for analysis. Demographic, biochemical, operative and pathological data were analyzed against survival outcomes. RESULTS: Forty-two patients were included for analysis. The median age was 53.5 years. There were 29 males. Hepatitis B virus was identified in 73.8% of the patients. Most patients had preserved liver function. The median preoperative indocyanine green retention rate at 15 min was 10.2%. The median tumor size was 6.5 cm. Major hepatectomy was required in over 70% of the patients. Hepaticojejunostomy was performed in 6 patients. No hospital death occurred. The median hospital stay was 13 d. The median follow-up period was 32 mo. The 5-year disease-free survival and overall survival were 23.6% and 35.4% respectively. Multifocality was the only independent factor associated with disease-free survival [P < 0.001, odds ratio 4, 95% confidence interval (CI): 1.9-8.0]. In patients with multifocal tumor (n = 20), resection margin of ≥ 1 cm was associated with improved 1-year disease-free survival (40% vs 0%; log-rank, P = 0.012). CONCLUSION: HCC-CC is a rare disease with poor prognosis. Resection margin of 1 cm or above was associated with improved survival outcome in patients with multifocal HCC-CC. Baishideng Publishing Group Inc 2017-05-08 2017-05-08 /pmc/articles/PMC5424293/ /pubmed/28539991 http://dx.doi.org/10.4254/wjh.v9.i13.635 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Ma, Ka Wing
Chok, Kenneth Siu Ho
Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title_full Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title_fullStr Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title_full_unstemmed Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title_short Importance of surgical margin in the outcomes of hepatocholangiocarcinoma
title_sort importance of surgical margin in the outcomes of hepatocholangiocarcinoma
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424293/
https://www.ncbi.nlm.nih.gov/pubmed/28539991
http://dx.doi.org/10.4254/wjh.v9.i13.635
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