Importance of surgical margin in the outcomes of hepatocholangiocarcinoma

• Published in: World journal of hepatology Vol. 9; no. 13; pp. 635 - 641
• Main Authors: Ma, Ka Wing, Chok, Kenneth Siu Ho
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 08.05.2017
• Subjects: Retrospective Study; Hepatocholangiocarcinoma; Hepatocellular cholangiocarcinoma; Resection margin; Survival; Hepatectomy
• ISSN: 1948-5182; 1948-5182
• DOI: 10.4254/wjh.v9.i13.635

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 from1995 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. RESULTSForty-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 diseasefree 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).CONCLUSIONHCC-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.