ABSTRACT
Objectives
The resection margin (RM) status and microscopic vascular invasion (MVI) are known prognostic factors for intrahepatic cholangiocarcinoma (ICC). An enhanced understanding of their impact on long-term prognosis is required to improve oncological outcomes.
Methods
A total of 711 consecutive patients who underwent curative liver resection for hepatitis B virus–related ICC were retrospectively analyzed. The different impact of the RM status (narrow, <1 cm, or wide, ≥1 cm) and MVI (positive, +, or negative, -) on overall survival (OS) and recurrence-free survival (RFS) were analyzed.
Results
The 1-, 3-, and 5-year OS rates were 67.6%, 42.5%, and 33.2% in wide RM & MVI (-), 58.0%, 36.1%, and 26.5% in narrow RM & MVI (-), 51.0%, 27.0%, and 24.3% in wide RM & MVI (+), and 39.0%, 20.4% and 14.3% in narrow RM & MVI (+) (p < 0.001). Multivariate analysis showed that RM & MVI were independent risk factors for the OS and RFS.
Conclusion
Combined analysis of RM and MVI can better stratify the risks of postoperative death and recurrence in patients with HBV-related ICC, which may help subsequent adjuvant therapy and closer follow-up.
Abbreviations
ICC, intrahepatic cholangiocarcinoma; HBV, hepatitis B virus; TBIL, total bilirubin; ALB, albumin; ALT, alanine aminotransferase; AST, aspartate transaminase; GGT, Gamma-glutamyltransferase; PT, prothrombin time; AFP, Alpha-fetoprotein; WRM, wide resection margin; NRM, narrow resection; MVI, microscopic vascular invasion; CI, confidence interval; HR, hazard ratio.
Declaration of interest
No potential conflict of interest was reported by the author(s).
Reviewer disclosures
Peer reviewers in this manuscript have no relevant financial or other relationship to disclose
Authors contributions
We Lu, P Chen and K Yan contributed equally to this work. H Zhang had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: H Zhang and Y Fu. Acquisition, analysis, or interpretation of data: W Lu, P Chen and K Yan. Drafting of the manuscript: W Lu and P Chen. Critical revision of the manuscript for important intellectual content: Y Wu. Statistical analysis: L Liang. Administrative, technical, or material support: J Yuan. All authors agree to be accountable for all aspects of the work.