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06.03.2019 | Hepatobiliary Tumors | Ausgabe 6/2019

Annals of Surgical Oncology 6/2019

Impact of Anatomical Versus Non-anatomical Liver Resection on Short- and Long-Term Outcomes for Patients with Intrahepatic Cholangiocarcinoma

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 6/2019
Autoren:
MD Anfeng Si, MD Jun Li, MD Zhishi Yang, MD Yong Xia, MD Tian Yang, MD Zhengqing Lei, MD Zhangjun Cheng, MD, PhD, MPH Timothy M. Pawlik, MD, FRCS, FACS, FRACS (Hon) Wan Yee Lau, MD, PhD Feng Shen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-019-07260-8) contains supplementary material, which is available to authorized users.
Anfeng Si, Jun Li, and Zhishi Yang have contributed equally to this work.

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Abstract

Objective

The aim of this study was to examine the impact of anatomical resection (AR) versus non-anatomical resection (NAR) on the survival outcomes in patients with intrahepatic cholangiocarcinoma (ICC).

Patients and Methods

Data on 702 consecutive patients who underwent either AR (n = 319) or NAR (n = 383) for ICC were reviewed. Disease-free survival (DFS) and overall survival (OS) following AR versus NAR was compared using propensity score matching (PSM). Subgroups of patients who benefited from AR versus NAR were examined after being stratified by the 8th TNM staging of ICC.

Results

AR and NAR had similar complication rates (26.6% vs. 25.1%, p = 0.634). AR was associated with better 1-, 3-, and 5-year DFS and OS rates compared with NAR after PSM (58.1%, 35.7% and 28.1% vs. 44.1%, 23.9% and 18.0%; 72.9%, 45.7% and 36.0% vs. 62.0%, 30.8% and 25.3%; both p = 0.002). On multivariate analysis, NAR was associated with worse DFS and OS than AR [hazard ratio (HR) 1.461 and 1.488; 95% confidence interval (CI) 1.184–1.804 and 1.189–1.863, respectively]. Stratified analysis demonstrated similar outcomes following AR versus NAR for ICC at stages IA, II with vascular invasion, and III with visceral peritoneum perforation, local extrahepatic invasion and nodal metastasis, while NAR was associated with worse DFS and OS versus AR for stages IB (HR 1.897 and 2.321; 95% CI 1.179–3.052 and 1.376–3.914, respectively) or II ICC without vascular invasion (2.071 and 2.077; 95% CI 1.239–3.462 and 1.205–3.579, respectively).

Conclusions

AR was associated with better survival outcomes compared with NAR in ICC patients with stage IB or II tumors without vascular invasion.

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Zusatzmaterial
Supplementary material 1 (DOCX 20 kb)
10434_2019_7260_MOESM1_ESM.docx
Supplementary material 2 (DOCX 25 kb)
10434_2019_7260_MOESM2_ESM.docx
Supplementary material 3 (DOCX 20 kb)
10434_2019_7260_MOESM3_ESM.docx
Supplementary material 4 (DOCX 24 kb)
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Supplementary material 5 (DOCX 27 kb)
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Supplementary material 6 (DOCX 20 kb)
10434_2019_7260_MOESM6_ESM.docx
DFS and OS rates after AR versus NAR for stage III ICC patients. (a) DFS rates in all stage III patients; (b) OS rates in all stage III patients; (c) DFS rates in stage IIIA patients without nodal metastasis; (d) OS rates in stage IIIA patients without nodal metastasis; (e) DFS rates in stage IIIB patients with nodal metastasis; (f) OS rates in stage IIIB patients with nodal metastasis. DFS disease-free survival, OS overall survival, AR anatomical resection, NAR non-anatomical resection, ICC intrahepatic cholangiocarcinoma (PDF 518 kb)
10434_2019_7260_MOESM7_ESM.pdf
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