Evidence map›Paper›PMID 36396868›Full record

ArticleAnnals of surgical oncology2023

Higher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Overall Survival in Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma.

Yutaka Endo, Kazunari Sasaki, Zorays Moazzam, Henrique A Lima, Laura Alaimo, Alfredo Guglielmi, Luca Aldrighetti, Matthew Weiss, Todd W Bauer, Sorin Alexandrescu and 11 more

Open access · greenAbstract read
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In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
6.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 31 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 16 institutions in 10 countries.

Yutaka EndoDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Kazunari SasakiDepartment of Surgery, Stanford University, Stanford, CA, USA.
Zorays MoazzamDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Henrique A LimaDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Laura AlaimoDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Alfredo GuglielmiDepartment of Surgery, University of Verona, Verona, Italy.
Luca AldrighettiDepartment of Surgery, Ospedale San Raffaele, Milan, Italy.
Matthew WeissDepartment of Surgery, John Hopkins Hospital, Baltimore, MD, USA.
Todd W BauerDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Sorin AlexandrescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Shishir K MaithelDepartment of Surgery, Emory University, Atlanta, GA, USA.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Guillaume MartelDepartment of Surgery, University of Ottawa, Ottawa, Canada.
Carlo PulitanoDepartment of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
Feng ShenDepartment of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
François CauchyDepartment of Hepatibiliopancreatic Surgery, APHP, Beaujon Hospital, Paris, France.
Bas Groot KoerkampDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Itaru EndoDepartment of Gastroenterological Surgery, Yokohama City, University School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870
The Ohio State University Wexner Medical Center · USStanford University · USUniversity of Verona · ITEmory University · USErasmus University Rotterdam · NLHôpital Beaujon · FRHospital Curry Cabral · PTInstitutul Clinic Fundeni · ROIRCCS Ospedale San Raffaele · ITJohns Hopkins Hospital · USKeio University · JPSecond Military Medical University · CNThe University of Sydney · AUUniversity of Ottawa · CAUniversity of Virginia · USYokohama City University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe present study aimed to examine the prognostic significance of margin status following hepatectomy of intrahepatic cholangiocarcinoma (ICC) relative to overall tumor burden and nodal status.

methodPatients who underwent curative-intent surgery for ICC between 1990 and 2017 were included from a multi-institutional database. The impact of margin status and width on overall survival (OS) was examined relative to TBS and preoperative nodal status.

resultsAmong 1105 patients with ICC who underwent resection, median tumor burden score (TBS) was 6.1 (IQR 4.2-8.8) and 218 (19.7%) patients had N1 disease. More than one in eight patients had an R1 surgical margin (n = 154, 13.9%). Among patients with low or medium TBS, an increasing margin width was associated with an incrementally improved 5-year OS (R1 31.9% vs. 1-3 mm 38.5% vs. 3-10 mm 48.0% vs. ≥ 10 mm 52.3%). In contrast, among patients with a high TBS, margin width was not associated with better survival (R1 28.9% vs. 1-3 mm 22.8% vs. 3-10 mm 29.6% vs. ≥ 10 mm 13.7%). In addition, surgical margin status did not impact survival with cutoffs of TBS 7 or greater. Furthermore, patients with low or medium TBS and preoperative negative lymph nodes derived a survival benefit from an R0 resection (R1 resection, HR 2.15, 95% CI 1.35-3.44, p = 0.001). In contrast, margin status was not associated with prognosis among patients with a high TBS and preoperative positive/suspicious lymph nodes (R1 resection, HR 1.34, 95% CI 0.58-3.11, p = 0.50).

conclusionR0 resection and wider margin resection resulted in improved outcomes in patients with low tumor burden; however, the survival benefit of negative margin status disappeared in patients with underlying poor tumor biology.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaBile Ducts, IntrahepaticHepatectomyHumansMargins of ExcisionPrognosisRetrospective StudiesSurvival RateTumor Burden

Identifiers

PMID36396868
OpenAlexW4309236284

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.