Impact of surgical margin width on long-term outcomes for intrahepatic cholangiocarcinoma: a multicenter study

BackgroundThe objective of this study was to investigate the survival outcomes of surgical margin width in intrahepatic cholangiocarcinoma (ICC).MethodsBetween November 2011 and August 2017, patients who underwent hepatectomy for ICC were collected from 13 major hepatopancreatobiliary centers in China. The survival outcomes for patients who underwent wide margin hepatectomy (WMH) were compared with those who underwent narrow margin hepatectomy (NMH) using the 1:1 propensity score matching (PSM).ResultsAmong 478 included patients, 195 (40.8%) underwent WMH whereas 283 (59.2%) underwent NMH. PSM yielded 79 matched patients with similar baseline characteristics. Patients underwent WMH had a significant better OS and DFS compared with those underwent NMH (before PSM: median OS 27 vs 17months, P<0.05; median DFS 15 vs 8months, P=0.001, after PSM: median OS 41 vs 22months, p<0.05; median DFS 16 vs 10months, p<0.05). However, subgroup analysis based on the AJCC staging system, WMH could only improve the survival outcomes in AJCC I ICC patients (Stage I: OS, DFS, P<0.05).ConclusionsSurgeons should strive to achieve a wide surgical margin for patients with AJCC I ICC to optimize the long-term outcome.