Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer
Margin positivity after hilar resection (HR) for bile duct cancer is commonly observed due to its longitudinal spread along the subepithelial plane; nevertheless, we cannot draw conclusions regarding the prognostic effects of margins with high-grade dysplasia (HGD) or carcinoma. We aimed to investig...
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MDPI AG
2023-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/21/5166 |
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| author | Hani Jassim Alramadhan Soo-Yeun Lim Hye-Jeong Jeong Hyun-Jeong Jeon Hochang Chae So-Jeong Yoon Sang-Hyun Shin In-Woong Han Jin-Seok Heo Hongbeom Kim |
| author_facet | Hani Jassim Alramadhan Soo-Yeun Lim Hye-Jeong Jeong Hyun-Jeong Jeon Hochang Chae So-Jeong Yoon Sang-Hyun Shin In-Woong Han Jin-Seok Heo Hongbeom Kim |
| author_sort | Hani Jassim Alramadhan |
| collection | DOAJ |
| description | Margin positivity after hilar resection (HR) for bile duct cancer is commonly observed due to its longitudinal spread along the subepithelial plane; nevertheless, we cannot draw conclusions regarding the prognostic effects of margins with high-grade dysplasia (HGD) or carcinoma. We aimed to investigate the oncologic effect according to the margin status after HR, particularly between the R1 HGD and the R1 carcinoma. From 2008 to 2017, 149 patients diagnosed with mid-bile duct cancer in Samsung Medical Center, South Korea, were divided according to margin status after HR and retrospectively analyzed. Recurrence patterns were also analyzed between the groups. There were 126 patients with R0 margins, nine with R1 HGD, and 14 with R1 carcinoma. The mean age of the patients was 68.3 (±8.1); most patients were male. The mean age was higher in R1 carcinoma patients than in R1 HGD and R0 patients (<i>p</i> = 0.014). The R1 HGD and R1 carcinoma groups had more patients with a higher T-stage than R0 (<i>p</i> = 0.079). In univariate analysis, the prognostic factors affecting overall survival were age, T- and N-stage, CA19-9, and margin status. The survival rate of R0 was comparable to that of R1 HGD, but the survival rate of R0 was significantly better compared to R1 carcinoma (R0 vs. R1 HGD, <i>p</i> = 0.215, R0 vs. R1 carcinoma, <i>p</i> = 0.042, respectively). The recurrence pattern between the margin groups did not differ significantly (<i>p</i> = 0.604). Extended surgery should be considered for R1 carcinoma; however, in R1 HGD, extended operation may not be necessary, as it may achieve oncologic outcomes similar to R0 margins with HR. |
| first_indexed | 2024-03-11T11:32:37Z |
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| id | doaj.art-6571bd2e089a46a4bd1516cd9071c004 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T11:32:37Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-6571bd2e089a46a4bd1516cd9071c0042023-11-10T15:00:05ZengMDPI AGCancers2072-66942023-10-011521516610.3390/cancers15215166Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct CancerHani Jassim Alramadhan0Soo-Yeun Lim1Hye-Jeong Jeong2Hyun-Jeong Jeon3Hochang Chae4So-Jeong Yoon5Sang-Hyun Shin6In-Woong Han7Jin-Seok Heo8Hongbeom Kim9Department of Surgery, King Fahad Hospital, Hofuf 36411, Saudi ArabiaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaDivision of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of KoreaMargin positivity after hilar resection (HR) for bile duct cancer is commonly observed due to its longitudinal spread along the subepithelial plane; nevertheless, we cannot draw conclusions regarding the prognostic effects of margins with high-grade dysplasia (HGD) or carcinoma. We aimed to investigate the oncologic effect according to the margin status after HR, particularly between the R1 HGD and the R1 carcinoma. From 2008 to 2017, 149 patients diagnosed with mid-bile duct cancer in Samsung Medical Center, South Korea, were divided according to margin status after HR and retrospectively analyzed. Recurrence patterns were also analyzed between the groups. There were 126 patients with R0 margins, nine with R1 HGD, and 14 with R1 carcinoma. The mean age of the patients was 68.3 (±8.1); most patients were male. The mean age was higher in R1 carcinoma patients than in R1 HGD and R0 patients (<i>p</i> = 0.014). The R1 HGD and R1 carcinoma groups had more patients with a higher T-stage than R0 (<i>p</i> = 0.079). In univariate analysis, the prognostic factors affecting overall survival were age, T- and N-stage, CA19-9, and margin status. The survival rate of R0 was comparable to that of R1 HGD, but the survival rate of R0 was significantly better compared to R1 carcinoma (R0 vs. R1 HGD, <i>p</i> = 0.215, R0 vs. R1 carcinoma, <i>p</i> = 0.042, respectively). The recurrence pattern between the margin groups did not differ significantly (<i>p</i> = 0.604). Extended surgery should be considered for R1 carcinoma; however, in R1 HGD, extended operation may not be necessary, as it may achieve oncologic outcomes similar to R0 margins with HR.https://www.mdpi.com/2072-6694/15/21/5166bile duct cancercholangiocarcinomahigh-grade dysplasia |
| spellingShingle | Hani Jassim Alramadhan Soo-Yeun Lim Hye-Jeong Jeong Hyun-Jeong Jeon Hochang Chae So-Jeong Yoon Sang-Hyun Shin In-Woong Han Jin-Seok Heo Hongbeom Kim Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer Cancers bile duct cancer cholangiocarcinoma high-grade dysplasia |
| title | Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer |
| title_full | Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer |
| title_fullStr | Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer |
| title_full_unstemmed | Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer |
| title_short | Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer |
| title_sort | different oncologic outcomes according to margin status high grade dysplasia vs carcinoma in patients who underwent hilar resection for mid bile duct cancer |
| topic | bile duct cancer cholangiocarcinoma high-grade dysplasia |
| url | https://www.mdpi.com/2072-6694/15/21/5166 |
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