Available online 29 February 2024, 102058

From our analysis of R0 resected ICC patients, resection margin width does not independently affect RFS and OS.

Narrower margins may be suitable for specific ICC subgroups, especially those with positive lymph nodes or borderline future liver remnants.

Lymph node involvement has a negative impact on overall survival, and vascular invasion is associated with poorer recurrence-free survival.

Intrahepatic cholangiocarcinoma is the second most common primary liver cancer after hepatocellular carcinoma with an increasing incidence worldwide. Surgical resection is still the only potential cure, and survival rates are dismal due to disease relapse after resection and/or metastatic disease. Positive resection margins are associated with recurrence, with conflicting studies regarding the benefits of wide resection margins to reduce recurrence rates.

126 patients with an R0 resection treated with hepatic surgery for intrahepatic cholangiocarcinoma at the Surgical Department at the Medical University Centre Essen, Germany were identified in a database and retrospectively analysed. Patients were grouped into three groups according to margin width, <1 mm (very narrow margin width) 1–5 mm (narrow margin width) and >5 mm (wide margin width). Epidemiological as well as perioperative data was analysed, and a univariate analysis as well as Kaplan-Meier plots carried out to investigate recurrence-free and overall survival.

Wider resection margins did not lead to better recurrence-free survival.

A wider resection margin >5 mm was not significantly associated with improved overall survival.

Positive lymph nodes (HR 2.50, 95% CI 1.11–5.61, p=0.027) and non-anatomic resections (HR 2.06, 95% CI 1.13–3.75, p=0.019) are significantly associated with poorer overall survival. Regarding recurrence-free survival, V2 vascular invasion was the only risk factor statistically significantly associated with poorer recurrence-free survival (HR 8.83, 95% CI 0.85–2.83, p=0.005).

Resection margins did not have a significant impact on disease free survival or overall survival following hepatic resection for intrahepatic cholangiocarcinoma. Non-anatomical resections, lymph node and vascular invasion all significantly impacted oncological outcomes.

© 2024 The Authors. Published by Elsevier Ltd.