Prognostic value of resection margin length after surgical resection for intrahepatic cholangiocarcinoma

Background: The definition and prognostic value of a wide resection margin remains controversial. The aim of this study was to assess the relevance of resection margin length for survival following intrahepatic cholangiocarcinoma (ICC) resection. Methods: Patients scheduled for curative resection for ICC between 2015 and 2018 were identified from an institutional database. Demographic data, pathological margin length, and oncologic outcomes were collected and analyzed. Results: This study included 126 patients, of whom 78% underwent anatomical hepatectomy. The resection margin was <0.5, <1.0, and <1.5 cm in 73 (60%), 92 (73%), and 109 (87%) patients, respectively. A resection margin >= 1.0 cm was associated with favorable overall survival (OS) (HR: 0.403; 95% CI: 0.191-0.854; P = 0.018) and recurrence-free survival (RFS) (HR: 0.436; 95% CI: 0.232-0.817; P = 0.010). In the anatomical hepatectomy group, a resection margin >= 1.0 cm was an independent predictor of superior OS (HR: 0.451; 95% CI: 0.208-0.977; P = 0.043) and RFS (HR: 0.470; 95% CI: 0.242-0.914; P = 0.026). Conclusions: A resection margin >= 1.0 cm was associated with significantly improved survival in ICC. Therefore, a clear margin of at least 1.0 cm should be achieved during ICC resection. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study suggests that a resection margin length >= 1.0 cm is associated with significantly improved survival in patients undergoing resection for intrahepatic cholangiocarcinoma (ICC). Therefore, achieving a clear margin of at least 1.0 cm during ICC resection is recommended for better outcomes.