Prognostic Impact of Margin Status in Distal Cholangiocarcinoma

Background A positive ductal margin is strongly associated with poor survival in patients with distal cholangiocarcinoma. However, the significance of the radial margin status and its effect on survival are not fully clarified. Methods All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between January 2000 and December 2018 at Tokai University Hospital were retrospectively analyzed. Positive margins were divided into positive ductal margin and positive radial margin. Results One hundred and eight consecutive patients with distal cholangiocarcinoma underwent pancreatoduodenectomy. Margin-negative R 0 resection was performed in 85 patients (79%). Twenty-three patients (21%) had a positive resection margin ( R 1 resection). The 5-year survival rate and median overall survival for patients with R 0 resection and those with R 1 resection was 64%, 98 months and 25%, 26 months, respectively. There was a significant difference in survival between patients with R 0 resection and those with R 1 resection ( p