Impaction of surgical margin status on the survival outcome after surgical resection of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis

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• 作者：Mu-xing Li ; MD^a ; Xin-yu Bi ; MD^a ; Zhi-yu Li ; MD^a ; Zhen Huang ; MD^a ; Yue Han ; MD^b ; Jian-jun Zhao ; MD^a ; Hong Zhao ; MD^a ; ^{zhaohong9@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Jian-qiang Cai ; MD^a ; ^{caijianqiang@cicams.ac.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Surgical margin ; Intrahepatic cholangiocarcinoma ; Prognosis ; Meta-analysis
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：1 June 2016
• 年：2016
• 卷：203
• 期：1
• 页码：163-173
• 全文大小：1033 K

文摘

Conflicting results about the prognostic value of surgical margin status in patients with intrahepatic cholangiocarcinoma (ICC) have been reported. We aimed to assess the association between surgical margin status and prognosis in ICC through a meta-analysis.

Materials and methods

We conducted a literature search of the articles evaluating the prognostic value of surgical margin status in patients with ICC. The pooled estimation of the hazard ratio (HR) with the 95% confidence interval (CI) was performed to determine the influence of surgical margin status on the survival outcome.

Results

A total of 21 studies involving 3201 patients were finally included into the meta-analysis. The percentage of patients with positive surgical margin ranged from 7.2% to 75.9% in the enrolled studies. The pooled estimates showed that patients with positive surgical margin had inferior overall survival (HR: 1.864; 95% CI: 1.542–2.252; P < 0.001) and progression-free survival (HR: 2.033; 95% CI: 1.030–4.011; P = 0.041) than patients with negative ones. The subgroup analyses and sensitivity analyses were consistent with the overall results.

Conclusions

Patients with negative surgical margin had significantly favorable overall survival and progression-free survival after surgical resection for ICC. The notion of achieving the R0 resection should be emphasized.