Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3078
Peer-review started: September 29, 2021
First decision: December 17, 2021
Revised: December 24, 2021
Accepted: February 15, 2022
Article in press: February 15, 2022
Published online: April 6, 2022
Processing time: 183 Days and 4.1 Hours
The status of the bile duct resection margin in extrahepatic cholangiocarcinoma (EHCC) is the most important indicator of recurrence and survival.
There is a lack of information regarding the meaning of dysplasia at the resection margin in EHCC. The clinical relevance of dysplasia in resection margins remains largely unknown, and no consensus has been reached.
This study aimed to evaluate the impact of dysplasia-positive margins as a prognostic indicator in patients with EHCC.
A total of 116 patients who had undergone surgery for EHCC with curative intent were enrolled in this study. Curative resection with free margins was achieved in 72 patients, while 44 patients had microscopic residual tumor at resection margins. Of the 44 patients, 19 carried low-grade dysplasia (LGD)-positive margins, and 25 showed high-grade dysplasia (HGD)/carcinoma in situ (CIS)-positive margins.
The mean survival rates of the patients with negative margins, LGD margins, and HGD/CIS margins were 49.1 ± 4.5, 47.3 ± 6.0, and 20.8 ± 4.4 mo, respectively (P < 0.001). There was no difference in survival between groups with LGD margins and negative margins (P = 0.56).
HGD/CIS margin in resected EHCC is associated with a poor survival and high tumor recurrence. However, LGD-positive margin is not a significantly poor prognostic factor in patients with EHCC.
This study provides meaningful information to establish a guideline for dysplasia-positive margins in patients with EHCC.