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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Cholangiocarcinoma | Research

Anatomic versus non-anatomic resection for early-stage intrahepatic cholangiocarcinoma: a propensity score matching and stabilized inverse probability of treatment weighting analysis

Authors: Qiao Ke, Lei Wang, Ziguo Lin, Hongzhi Liu, Jianying Lou, Shuguo Zheng, Xinyu Bi, Jianming Wang, Wei Guo, Fuyu Li, Jian Wang, Yamin Zheng, Jingdong Li, Shi Cheng, Weiping Zhou, Jingfeng Liu, Yongyi Zeng

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

Radical resection is still the most cost-effectiveness curative strategy for intrahepatic cholangiocarcinoma (ICC), but it remains controversial on the survival benefit of anatomic resection (AR). In this study, we sought to compare the oncologic outcomes between AR versus non-AR (NAR) as the primary treatment for early-stage ICC patients.

Methods

Data of ICC patients who underwent hepatectomy and staged at AJCC I were retrospectively collected from 12 hepatobiliary centers in China between Dec 2012 and Dec 2015. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (IPTW) analysis were performed to minimize the effect of potential confounders, and the perioperative and long-term outcomes between AR and NAR groups were compared.

Results

Two hundred seventy-eight ICC patients staged at AJCC I were eligible for this study, including 126 patients receiving AR and 152 patients receiving NAR. Compared to the NAR group, the AR group experienced more intraoperative blood loss before and after PSM or stabilized IPTW (all P > 0.05); AR group also experienced more intraoperative transfusion after stabilized IPTW (P > 0.05). In terms of disease-free survival (DFS) and overall survival (OS), no significant differences were observed between the two groups before and after PSM or stabilized IPTW (all P > 0.05). Multivariable Cox regression analyses found that AR was not an independent prognostic factor for either DFS or OS (all P > 0.05). Further analysis also showed that the survival benefit of AR was not found in any subgroup stratified by Child–Pugh grade (A or B), cirrhosis (presence or absence), tumor diameter (≤ 5 cm or > 5 cm) and pathological type (mass-forming or non-mass-forming) with all P > 0.05.

Conclusion

Surgical approach does not influence the prognosis of patients with stage I primary ICC, and NAR might be acceptable and oncological safety.
Appendix
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Metadata
Title
Anatomic versus non-anatomic resection for early-stage intrahepatic cholangiocarcinoma: a propensity score matching and stabilized inverse probability of treatment weighting analysis
Authors
Qiao Ke
Lei Wang
Ziguo Lin
Hongzhi Liu
Jianying Lou
Shuguo Zheng
Xinyu Bi
Jianming Wang
Wei Guo
Fuyu Li
Jian Wang
Yamin Zheng
Jingdong Li
Shi Cheng
Weiping Zhou
Jingfeng Liu
Yongyi Zeng
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11341-z

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