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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2008

01-10-2008 | Hepatic and Pancreatic Tumors

Influence of Hepatic Resection Margin on Recurrence and Survival in Intrahepatic Cholangiocarcinoma

Authors: Dietmar Tamandl, MD, Beata Herberger, MSc, Birgit Gruenberger, MD, Harald Puhalla, MD, Markus Klinger, MD, Thomas Gruenberger, MD

Published in: Annals of Surgical Oncology | Issue 10/2008

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Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is a rare disease in the Western world, hence little is known about its optimal surgical management. We analyzed whether hepatic resection margin is a prognostic factor for local or distant recurrence and survival in patients resected with curative intent.

Methods

Seventy-four patients underwent potentially curative surgery for ICC at our institution from 1994 to 2007. Demographic, and tumor- and surgery-related details including hepatic resection margin were recorded, patients were followed up for recurrence and survival. All patients were resected using modern dissection devices (CUSA® or Waterjet®).

Results

Fifty-nine patients (80%) underwent R0 resection, 15 (20%) had a resection margin greater than 10 mm (wide margin, WM) and 38 (51%) between 1 and 10 mm (close margin, CM). In 14 patients (19%), hepatic resection margin was involved on histological examination; perioperative mortalities were excluded from analysis (n = 7). Forty-seven patients developed recurrence (WM, CM, and R1): hepatic recurrence was observed in 40%, 58%, and 50% of patients; extrahepatic spread occurred in 27, 16, and 14%; and 33, 26, and 36% had no recurrence of disease so far (P = 0.755). There was no difference between groups regarding local versus disseminated hepatic recurrence. Median recurrence free survival was 11.4 months (WM), 9.8 months (CM), and 9.9 months (R1), respectively (P = 0.880). Median overall survival was 27.2 months (WM), 29.7 months (CM), and not reached in the R1 group, (P = 0.350).

Conclusion

Hepatic resection margin seems to play a minor role in the prognosis of ICC as long as complete tumor clearance can be achieved with a modern liver dissection technique.
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Metadata
Title
Influence of Hepatic Resection Margin on Recurrence and Survival in Intrahepatic Cholangiocarcinoma
Authors
Dietmar Tamandl, MD
Beata Herberger, MSc
Birgit Gruenberger, MD
Harald Puhalla, MD
Markus Klinger, MD
Thomas Gruenberger, MD
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-0081-1

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