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Effectiveness of additional resection of the invasive cancer-positive proximal bile duct margin in cases of hilar cholangiocarcinoma

   
@article{HBSN19227,
	author = {Wen-Jie Ma and Zhen-Ru Wu and Anuj Shrestha and Qin Yang and Hai-Jie Hu and Jun-Ke Wang and Fei Liu and Rong-Xing Zhou and Quan-Sheng Li and Fu-Yu Li},
	title = {Effectiveness of additional resection of the invasive cancer-positive proximal bile duct margin in cases of hilar cholangiocarcinoma},
	journal = {Hepatobiliary Surgery and Nutrition},
	volume = {7},
	number = {4},
	year = {2018},
	keywords = {},
	abstract = {Background: The survival benefits of additional resection of the positive proximal ductal margin (PM) in hilar cholangiocarcinoma (HCCA) remains controversial. This retrospective study investigated the effectiveness of additional resection of the invasive cancer PM under different levels of preoperative carbohydrate antigen 19-9 (CA19-9).
Methods: Patients who underwent hepatectomy for HCCA from 2000 to 2017 were analyzed. Surgical variables, resection margin status, length of the PM (LPM), prognostic factors, and survival were evaluated. 
Results: A total of 228 patients were enrolled: 175 PM(−) without additional resection patients (group A),  21 PM(−) after additional resection (group B), 16 PM(+) without additional resection (group C), and 16 PM(+)  after additional resection (group D). The median survival of group B (20.99 months) was similar to that of group A (23.00 months; P=0.16), and both were significantly better than those of group C (11.60 months) and D (9.50 months), especially when preoperative CA19-9>150 U/mL (P10 mm was significantly better compared with those with an LPM ≤10 mm, especially when preoperative CA19-9 was >150 U/ml (P10 mm group, the survival of group B was comparable with that of group A (P>0.05).
Conclusions: HCCA patients could get a survival benefit from a negative PM resulting from additional resection. Survival could be comparable with that of negative PM without additional resection among HCCA patients. An LPM >10 mm is possibly more associated with better survival compared with whether additional resection of the positive PM is performed under different levels of preoperative CA19-9.},
	issn = {2304-389X},	url = {https://hbsn.amegroups.org/article/view/19227}
}