Introduction: The purpose of this study was to analyze survival outcomes after segmental bile duct resection (BDR) for mid-common bile duct cancer according to the length of the tumor-free BDR margins. Method: A total of 133 consecutive patients underwent BDR for mid-bile duct cancers between December 2007 and June 2017. The Cox proportional hazard model was used to verify the cutoff value of the R0 resection margin. The patients were divided into 3 groups according to resection margin status (group 1; R0 resection margin ≥5 mm; group 2, R0 resection margin #x3c;5 mm; and group 3, R1 resection margin). Results: The median follow-up period of the study cohort was 24 months. A resection margin of 5 mm in length was verified to be suitable as a reliable cutoff value. The median disease-free and overall survival (OS) periods were 32 and 49 months in group 1, 13 and 20 months in group 2, and 23 and 30 months in group 3, respectively (p = 0.03 and p #x3c; 0.001). The length of the tumor-free resection margin (hazard ratio, 2.01; 95% confidence interval, 1.10–3.67; p = 0.022) was independent factor affecting OS. Conclusions: BDR for mid-bile duct cancer appears to be a feasible surgical option in selected patients with careful preoperative imaging assessment and intraoperative frozen-section diagnosis. Our results suggest achieving a BDR margin ≥5 mm to improve survival outcomes.
Dig Surg

中文翻译：

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中段胆管癌切除边缘长度对预后的影响：单中心经验

简介：本研究的目的是根据无瘤 BDR 切缘的长度分析胆总管中部癌节段性胆管切除术 (BDR) 后的生存结果。方法： 2007年12月至2017年6月共133例胆管中段癌患者连续接受BDR，采用Cox比例风险模型验证R0切缘临界值。根据切缘状态将患者分为 3 组（第 1 组；R0 切缘≥5 mm；第 2 组，R0 切缘 #x3c；5 mm；第 3 组，R1 切缘）。结果：研究队列的中位随访期为 24 个月。经证实，长度为 5 mm 的切缘适合作为可靠的临界值。第 1 组的中位无病生存期和总生存期 (OS) 分别为 32 和 49 个月，第 2 组为 13 个月和 20 个月，第 3 组分别为 23 和 30 个月（p = 0.03 和p #x3c；0.001） . 无瘤切缘的长度（风险比，2.01；95% 置信区间，1.10-3.67；p = 0.022）是影响 OS 的独立因素。结论：对于经过仔细术前影像学评估和术中冰冻切片诊断的特定患者，胆管中段癌 BDR 似乎是一种可行的手术选择。我们的结果表明，实现 BDR 边缘≥5 mm 以改善生存结果。
挖掘外科