The influence of resection margin width in patients with intrahepatic cholangiocarcinoma: a meta-analysis

Abstract

Background Some studies have pointed out that a wide resection margin can improve the prognosis of intrahepatic cholangiocarcinoma, but some researchers disagree and believe that a wide margin may increase complications. The optimal margin length of intrahepatic cholangiocarcinoma is controversial. Method The literature was searched in PubMed, MedLine, Embase, the Cochrane Library, and Web of Science until December 31, 2021, to evaluate the postoperative outcomes of patients with different margin width after resection. Odds ratios (ORs) with 95% confidence intervals were used to determine the effect size. Result A total of 11 articles were included in this meta-analysis, including 3007 patients. The narrow group had significantly lower 1-, 3-, and 5-year overall survival rates and recurrence-free survival rates than the wide group. Postoperative morbidity and prognostic factors were also evaluated. Conclusion A resection margin width of over 10 mm is recommended in intrahepatic cholangiocarcinoma patients, especially in patients with negative lymph node and early tumor stage. When the resection margin width cannot be greater than 10 mm, we should ensure that the resection margin width is greater than 5 mm.

Preoperative serum CA125 level is a good prognostic predictor in patients with intrahepatic cholangiocarcinoma after hepatectomy: A single-center retrospective study

“…A histologically positive resected margin is a risk factor in the prognosis of ICC patients. [17,18] It is generally believed that it is more difficult to assess the prognosis of ICC patients with R0 resected margins after surgery. However, the results of this study showed that CA125 had a significant ability to predict the prognosis of ICC patients.…”

Management of Intrahepatic Cholangiocarcinoma: A Narrative Review

“…Additionally, margin width has been independently associated with recurrence-free and overall survival with margins less than one centimeter associated with poorer survival as compared to larger margins [23]. A meta-analysis that included a total of 3007 patients from eleven studies found that achieving a margin width of more than five or ten millimeters was significant in improving survival [24]. While parenchymal-sparing resections have been well-established in the surgical treatment of HCC and colorectal liver metastases, the impact of nonanatomic resection for ICC on long-term outcomes remains debated [25,26].…”

A narrative review of intrahepatic cholangiocarcinoma: a surgical curative option

“…Free surgical margin is a well described factor influencing recurrencefree survival (RFS) and overall survival (OS). Indeed, positive margin status was identified as strong factors for unfavourable prognosis in patients underwent resection (15,16). Moreover, surgical margins <1 cm is linked to worse prognosis compared to margin more than 1 cm (17).…”