Clinical impact of the surgical margin status in hepatectomy for solitary mass-forming type intrahepatic cholangiocarcinoma without lymph node metastases.

摘要

BACKGROUND AND OBJECTIVES: The clinical impact of the surgical margin status in macroscopic curative hepatectomy for intrahepatic cholangiocarcinoma (ICC) has not yet been fully investigated. METHODS: The data of 57 consecutive patients with mass-forming (MF) type ICC who underwent macroscopic curative hepatectomy during a 10-year period were retrospectively examined, and the relationship between the surgical margin status and patient survival was analyzed. RESULTS: Lymph node metastases were found to be independently associated with poor survival. The overall 5-year survival rates and the median survival term in the 38 patients without lymph node metastases were 56.8% and 62 months, respectively. Among these 38 patients, the survival rate was better in the negative surgical margin group as compared with that in the positive surgical margin group. However, there was no statistically significant difference between the narrow and wide surgical margin groups. CONCLUSIONS: Negative surgical margin had a definite favorable impact on the survival of patients with a solitary ICC without lymph node metastases. Surgery should be conducted in patients without lymph node metastases even if a wide surgical margin cannot be obtained, but careful attention should be paid not to expose tumors during hepatic dissection.