title: Influence of surgical margins on overall survival after resection of intrahepatic cholangiocarcinoma: A meta-analysis.
abstract: BACKGROUND
  Surgical resection is shown to present the best chance of cure in the treatment of intrahepatic cholangiocarcinoma (ICC). However, the appropriate length of the negative margin remains unclear. The aim of the present meta-analysis was to investigate whether a clear margin of 10 mm or more (≥10 mm) conferred any survival benefit over a margin of less than 10 mm (<10 mm) in patients with resected ICC.
  
  
  METHODS
  The meta-analysis was conducted in adherence with the PRISMA guidelines. PubMed, Web of Science, EMBASE, and the Cochrane Library were systematically searched to identify eligible studies published in English from the initiation of the databases to February 2016. Overall survival rates were pooled by using the hazard ratio and the corresponding 95% confidence interval (CI). Random-effect models were utilized because of between-study heterogeneity.
  
  
  RESULTS
  Six studies (eight cohorts) reporting on 712 patients were analyzed: 269 (37.80%) were in the 10 mm or more negative margin group, and 443 (62.20%) were in the less than 10 mm negative margin group. The pooled hazard ratio for the less than 10 mm group was found to be 1.59 (95% CI: 1.09-2.32) when this group was compared with the 10 mm or more group (reference), with moderate between-study heterogeneity (I = 45.30%, P = 0.07). Commensurate results were identified by sensitivity analysis.
  
  
  CONCLUSIONS
  The result of this meta-analysis suggests a long-term survival (overall survival) advantage for negative margins of 10 mm or more in comparison with negative margins less than 10 mm for patients undergoing surgical resection of ICC.
authors: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital Medical School of Chinese PLA, Haidian Center for Hepatopancreatobiliary Diseases, Beijing Tsinghua Changgung Hospital, Tsinghua University Medical Center, Changping, Beijing, China.
authors: Haowen
authors: H
authors: Tang
authors: Wenping
authors: W
authors: Lu
authors: Bingmin
authors: B
authors: Li
authors: Xuan
authors: X
authors: Meng
authors: Jiahong
authors: J
authors: Dong
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000072662:Margins of Excision; D015996:Survival Rate