Choe JW, Kim HJ, Kim JS. Significance of dysplasia in bile duct resection margin in patients with extrahepatic cholangiocarcinoma: A retrospective analysis. World J Clin Cases 2022; 10(10): 3078-3087 [PMID: 35647116 DOI: 10.12998/wjcc.v10.i10.3078]
Corresponding Author of This Article
Hyo Jung Kim, MD, PhD, Professor, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. hjkimmd@korea.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2022; 10(10): 3078-3087 Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3078
Significance of dysplasia in bile duct resection margin in patients with extrahepatic cholangiocarcinoma: A retrospective analysis
Jung Wan Choe, Hyo Jung Kim, Jae Seon Kim
Jung Wan Choe, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, South Korea
Hyo Jung Kim, Jae Seon Kim, Department ofInternal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, South Korea
Author contributions: Kim HJ designed the study; Kim HJ drafted the work; Kim JS, Kim HJ, and Choe JW collected the data; Choe JW analyzed and interpreted the data and wrote the article.
Supported bythe National Research Foundation of Korea, No. 2019R1C1C1003661.
Institutional review board statement: The study was reviewed and approved by the Korea University Ansan Hospital (2021AS0282).
Informed consent statement: The requirement for informed consent was waived by the committee because of the retrospective nature of the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyo Jung Kim, MD, PhD, Professor, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, South Korea. hjkimmd@korea.ac.kr
Received: September 27, 2021 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
ARTICLE HIGHLIGHTS
Research background
The status of the bile duct resection margin in extrahepatic cholangiocarcinoma (EHCC) is the most important indicator of recurrence and survival.
Research motivation
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.
Research objectives
This study aimed to evaluate the impact of dysplasia-positive margins as a prognostic indicator in patients with EHCC.
Research methods
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.
Research results
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).
Research conclusions
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.
Research perspectives
This study provides meaningful information to establish a guideline for dysplasia-positive margins in patients with EHCC.
