title: Clinical impact of the surgical margin status in hepatectomy for solitary mass-forming type intrahepatic cholangiocarcinoma without lymph node metastases.
abstract: OBJECTIVE
  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.
authors: Department of Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Japan. kshimada@ncc.go.jp
authors: Kazuaki
authors: K
authors: Shimada
authors: Tsuyoshi
authors: T
authors: Sano
authors: Yoshihiro
authors: Y
authors: Sakamoto
authors: Minoru
authors: M
authors: Esaki
authors: Tomoo
authors: T
authors: Kosuge
authors: Hidenori
authors: H
authors: Ojima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome