Journal
WORLD JOURNAL OF HEPATOLOGY
Volume 9, Issue 13, Pages 635-641Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.4254/wjh.v9.i13.635
Keywords
Hepatocholangiocarcinoma; Hepatocellular cholangiocarcinoma; Survival; Hepatectomy; Resection margin
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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 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). 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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