The impact of resection margin status according to lymph node metastasis on the survival outcome of perihilar cholangiocarcinoma

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-02-05 DOI:10.1016/j.amjsurg.2025.116236

Poowanai Sarkhampee, Weeris Ouransatien, Satsawat Chansitthichok, Nithi Lertsawatvicha, Paiwan Wattanarath

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Abstract

Background

The prognostic factors for overall survival (OS) in perihilar cholangiocarcinoma (pCCA) included resection margin (RM) and lymph node metastases (LNM). Nevertheless, the advantage associated with a negative RM in patients with LNM remains unresolved.

Methods

The study retrospectively analyzed patients with pCCA underwent curative-intent resection between October 2013 and December 2018. The evaluation of the OS was conducted based on the presence of LNM and the status of RM.

Results

Of the 167 resected pCCA patients, 87 (52.1 %) were LNM negative, and 80 (47.9 %) were LNM positive. Of the 87 LNM-negative patients, 68 (78.2 %) were R0 resections, and 19 (21.8 %) were R1 resections. In LNM-negative patients, the OS was longer in the R0 resection than the R1 resection group (median survival time (MST) of 32.1 vs 15.7 months, respectively; p < 0.001). Of the 80 LNM-positive patients, 35 were R0 resections and 45 were R1 resections. Among patients with LNM positivity, the OS rates were similar between the groups who underwent R1 resection and R0 resection (MST of 8.4 vs 8.0 months, respectively; p = 0.109).

Conclusion

In patients with pCCA, the RM status was the most important prognostic factor for LNM-negative patients. However, there was no impact in LNM-positive patients.

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肝门周围胆管癌淋巴结转移切缘状态对生存预后的影响

肝门周围胆管癌（pCCA）总生存期（OS）的预后因素包括切除边缘（RM）和淋巴结转移（LNM）。然而，与LNM患者阴性RM相关的优势仍未得到解决。方法回顾性分析2013年10月至2018年12月期间接受治愈性切除的pCCA患者。根据LNM的存在和RM的状态对OS进行评估。结果167例pCCA患者中LNM阴性87例（52.1%），LNM阳性80例（47.9%）。87例lnm阴性患者中，R0切除68例（78.2%），R1切除19例（21.8%）。在lnm阴性患者中，R0切除组的生存期长于R1切除组(中位生存时间（MST）分别为32.1个月和15.7个月；p & lt;0.001)。80例lnm阳性患者中，R0切除35例，R1切除45例。在LNM阳性患者中，R1切除术组和R0切除术组的OS率相似(MST分别为8.4个月和8.0个月；p = 0.109)。结论在pCCA患者中，RM状态是lnm阴性患者最重要的预后因素。然而，在lnm阳性患者中没有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.

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