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肝内胆管细胞癌患者切缘宽度的影响:一项荟萃分析。

The influence of resection margin width in patients with intrahepatic cholangiocarcinoma: a meta-analysis.

机构信息

Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China.

出版信息

World J Surg Oncol. 2023 Jan 20;21(1):16. doi: 10.1186/s12957-023-02901-5.

Abstract

BACKGROUND

Some studies have pointed out that a wide resection margin can improve the prognosis of intrahepatic cholangiocarcinoma, but some researchers disagree and believe that a wide margin may increase complications. The optimal margin length of intrahepatic cholangiocarcinoma is controversial.

METHOD

The literature was searched in PubMed, MedLine, Embase, the Cochrane Library, and Web of Science until December 31, 2021, to evaluate the postoperative outcomes of patients with different margin width after resection. Odds ratios (ORs) with 95% confidence intervals were used to determine the effect size.

RESULT

A total of 11 articles were included in this meta-analysis, including 3007 patients. The narrow group had significantly lower 1-, 3-, and 5-year overall survival rates and recurrence-free survival rates than the wide group. Postoperative morbidity and prognostic factors were also evaluated.

CONCLUSION

A resection margin width of over 10 mm is recommended in intrahepatic cholangiocarcinoma patients, especially in patients with negative lymph node and early tumor stage. When the resection margin width cannot be greater than 10 mm, we should ensure that the resection margin width is greater than 5 mm.

摘要

背景

一些研究指出,广泛的切除边缘可以改善肝内胆管癌的预后,但也有一些研究人员不同意这一观点,认为广泛的边缘可能会增加并发症。肝内胆管癌的最佳边缘长度存在争议。

方法

检索 PubMed、MedLine、Embase、Cochrane 图书馆和 Web of Science 中的文献,截至 2021 年 12 月 31 日,评估不同切除边缘宽度患者的术后结局。使用比值比(ORs)和 95%置信区间来确定效应量。

结果

这项荟萃分析共纳入 11 篇文章,共 3007 名患者。窄切缘组的 1 年、3 年和 5 年总生存率和无复发生存率明显低于宽切缘组。还评估了术后发病率和预后因素。

结论

建议肝内胆管癌患者的切除边缘宽度超过 10 mm,尤其是在淋巴结阴性和肿瘤早期的患者中。当无法大于 10 mm 时,应确保切除边缘宽度大于 5 mm。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/9854153/f2a6044ad517/12957_2023_2901_Fig1_HTML.jpg

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