Repository logo
 
Publication

Higher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Overall Survival in Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma

2022Journal article Open access
Simple item page
dc.contributor.authorEndo, Y
dc.contributor.authorSasaki, K
dc.contributor.authorMoazzam, Z
dc.contributor.authorLima, H
dc.contributor.authorAlaimo, L
dc.contributor.authorGuglielmi, A
dc.contributor.authorAldrighetti, L
dc.contributor.authorWeiss, M
dc.contributor.authorBauer, T
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPoultsides, G
dc.contributor.authorKitago, M
dc.contributor.authorMaithel, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorMartel, G
dc.contributor.authorPulitano, C
dc.contributor.authorShen, F
dc.contributor.authorCauchy, F
dc.contributor.authorKoerkamp, B
dc.contributor.authorEndo, I
dc.contributor.authorPawlik, T
dc.date.accessioned2024-08-22T13:50:12Z
dc.date.available2024-08-22T13:50:12Z
dc.date.issued2022
dc.description.abstractBackground: The present study aimed to examine the prognostic significance of margin status following hepatectomy of intrahepatic cholangiocarcinoma (ICC) relative to overall tumor burden and nodal status. Method: Patients who underwent curative-intent surgery for ICC between 1990 and 2017 were included from a multi-institutional database. The impact of margin status and width on overall survival (OS) was examined relative to TBS and preoperative nodal status. Results: Among 1105 patients with ICC who underwent resection, median tumor burden score (TBS) was 6.1 (IQR 4.2-8.8) and 218 (19.7%) patients had N1 disease. More than one in eight patients had an R1 surgical margin (n = 154, 13.9%). Among patients with low or medium TBS, an increasing margin width was associated with an incrementally improved 5-year OS (R1 31.9% vs. 1-3 mm 38.5% vs. 3-10 mm 48.0% vs. ≥ 10 mm 52.3%). In contrast, among patients with a high TBS, margin width was not associated with better survival (R1 28.9% vs. 1-3 mm 22.8% vs. 3-10 mm 29.6% vs. ≥ 10 mm 13.7%). In addition, surgical margin status did not impact survival with cutoffs of TBS 7 or greater. Furthermore, patients with low or medium TBS and preoperative negative lymph nodes derived a survival benefit from an R0 resection (R1 resection, HR 2.15, 95% CI 1.35-3.44, p = 0.001). In contrast, margin status was not associated with prognosis among patients with a high TBS and preoperative positive/suspicious lymph nodes (R1 resection, HR 1.34, 95% CI 0.58-3.11, p = 0.50). Conclusion: R0 resection and wider margin resection resulted in improved outcomes in patients with low tumor burden; however, the survival benefit of negative margin status disappeared in patients with underlying poor tumor biology.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol . 2023 Apr;30(4):2023-2032.pt_PT
dc.identifier.doi10.1245/s10434-022-12803-7pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/5001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectBile Duct Neoplasms* / pathologypt_PT
dc.subjectPrognosispt_PT
dc.subjectBile Ducts, Intrahepatic / pathologypt_PT
dc.subjectCholangiocarcinoma* / pathologypt_PT
dc.subjectHepatectomypt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectMargins of Excisionpt_PT
dc.subjectSurvival Ratept_PT
dc.subjectTumor Burdenpt_PT
dc.titleHigher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Overall Survival in Patients Undergoing Resection of Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2032pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage2023pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Ann Surg Oncol 2023_2023.pdf
Size:
471.5 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

CIR - Artigos