Prognostic value of resection margin and lymph node status in perihilar cholangiocarcinoma

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Hpb Pub Date : 2025-01-01 DOI:10.1016/j.hpb.2024.09.012

Faruk Koca , Ekaterina Petrova , Hanan El Youzouri, Jan Heil, Michael Heise, Svenja Sliwinski, Wolf O. Bechstein, Andreas A. Schnitzbauer

{"title":"Prognostic value of resection margin and lymph node status in perihilar cholangiocarcinoma","authors":"Faruk Koca , Ekaterina Petrova , Hanan El Youzouri, Jan Heil, Michael Heise, Svenja Sliwinski, Wolf O. Bechstein, Andreas A. Schnitzbauer","doi":"10.1016/j.hpb.2024.09.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The impact of resection margin and lymph node status on survival in patients undergoing resection for perihilar cholangiocarcinoma (pCCA) is controversial. The aim of this study was to investigate the influence of nodal and resection margin status on long-term survival after resection for pCCA.</div></div><div><h3>Methods</h3><div>Retrospective analysis of patients resected for pCCA at the University Hospital Frankfurt, Germany between 1999 and 2022. The patients were categorized in four groups according to resection margin (R) and nodal status (N). Survival was analyzed with univariable and multivariable Cox regression.</div></div><div><h3>Results</h3><div>Out of 123 patients, 100 with long-term survival were included in the survival analysis. In the univariable analysis, negative resection margin (p = 0.02) and lower grade (p = 0.004) were the only significant positive prognostic factors, while the difference between N0 and N+ was not statistically significant (p = 0.062). Median survival in the groups R0N0, R0N+, R + N0 and R+N+ groups was 40.1, 29.9, 18.4 and 18.9 months, respectively (p = 0.03). In the multivariable analysis, after adjusting for grade, nodal and resection margin status, only grade and resection margin had prognostic significance.</div></div><div><h3>Conclusion</h3><div>Patients with negative resection margin after resection for pCCA have a better prognosis, regardless of the presence of lymph node metastases.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 1","pages":"Pages 71-79"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1365182X24023293","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The impact of resection margin and lymph node status on survival in patients undergoing resection for perihilar cholangiocarcinoma (pCCA) is controversial. The aim of this study was to investigate the influence of nodal and resection margin status on long-term survival after resection for pCCA.

Methods

Retrospective analysis of patients resected for pCCA at the University Hospital Frankfurt, Germany between 1999 and 2022. The patients were categorized in four groups according to resection margin (R) and nodal status (N). Survival was analyzed with univariable and multivariable Cox regression.

Results

Out of 123 patients, 100 with long-term survival were included in the survival analysis. In the univariable analysis, negative resection margin (p = 0.02) and lower grade (p = 0.004) were the only significant positive prognostic factors, while the difference between N0 and N+ was not statistically significant (p = 0.062). Median survival in the groups R0N0, R0N+, R + N0 and R+N+ groups was 40.1, 29.9, 18.4 and 18.9 months, respectively (p = 0.03). In the multivariable analysis, after adjusting for grade, nodal and resection margin status, only grade and resection margin had prognostic significance.

Conclusion

Patients with negative resection margin after resection for pCCA have a better prognosis, regardless of the presence of lymph node metastases.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

肝周胆管癌切除边缘和淋巴结状态的预后价值

背景：切除边缘和淋巴结状态对接受肝周胆管癌（pCCA）切除术患者生存率的影响存在争议。本研究旨在探讨结节和切除边缘状态对pCCA切除术后长期生存的影响：方法：对 1999 年至 2022 年期间在德国法兰克福大学医院接受 pCCA 切除术的患者进行回顾性分析。根据切除边缘（R）和结节状态（N）将患者分为四组。采用单变量和多变量考克斯回归法分析了患者的生存率：结果：在123名患者中，有100名长期存活者被纳入生存分析。在单变量分析中，阴性切除边缘（p = 0.02）和较低分级（p = 0.004）是唯一显著的阳性预后因素，而 N0 和 N+ 之间的差异无统计学意义（p = 0.062）。R0N0组、R0N+组、R + N0组和R+N+组的中位生存期分别为40.1个月、29.9个月、18.4个月和18.9个月（p = 0.03）。在多变量分析中，调整分级、结节和切除边缘状态后，只有分级和切除边缘具有预后意义：结论：无论是否存在淋巴结转移，pCCA切除术后切除缘阴性的患者预后较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).