{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T09:21:12Z","timestamp":1781169672960,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,4,6]],"date-time":"2016-04-06T00:00:00Z","timestamp":1459900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Frozen section analysis (<jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content>) during cancer surgery is widely used to assess resection margins. However, in hilar cholangiocarcinoma (<jats:styled-content style=\"fixed-case\">HCCA<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> may be less reliable because of the specific growth characteristics of the tumor. The aim of this study was to determine the accuracy and consequences of intraoperative <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> of the proximal bile duct margins in <jats:styled-content style=\"fixed-case\">HCCA<\/jats:styled-content>. Between 1990 and 2014, 67 patients underwent combined extrahepatic bile duct resection and partial liver resection for <jats:styled-content style=\"fixed-case\">HCCA<\/jats:styled-content> with the use of <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content>. Sensitivity and specificity of <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> was 68% and 97%, respectively. Seventeen of 67 patients (25%) displayed a positive bile duct margin at <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content>. The false\u2010negative rate was 16% (eight patients). Ten patients (15%) with a positive bile duct margin underwent an additional resection in an attempt to achieve negative margins, which succeeded in three patients (4%). However, only one of these three patients did not have concomitant lymph node metastases, which are associated with a poor prognosis by itself. The use of <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> of the proximal bile duct is of limited clinical value because of the relatively low sensitivity, high risk of false\u2010negative results, and the low rate of secondary obtained tumor\u2010free resection margins. Supported by the literature, a new approach to the use of <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">HCCA<\/jats:styled-content> should be adopted, reserving the technique only for cases in which a substantial additional resection is possible.<\/jats:p>","DOI":"10.1002\/cam4.693","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T16:51:22Z","timestamp":1460307082000},"page":"1373-1380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Intraoperative frozen section analysis of the proximal bile ducts in hilar cholangiocarcinoma is of limited value"],"prefix":"10.1002","volume":"5","author":[{"given":"Hendrik T.J.","family":"Mantel","sequence":"first","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrie C.","family":"Westerkamp","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egbert","family":"Sieders","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M. 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G.","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koert P.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke T.","family":"Boer","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben H.","family":"de Kleine","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette S. H.","family":"Gouw","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Porte","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreatico\u2010Biliary Surgery and Liver Transplantation University of Groningen University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67530-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181afe0ab"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.05.053"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000251366.62632.d3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1177\/000313481007601129","article-title":"Univariate and multivariate analysis of prognostic factors in the surgical treatment of hilar cholangiocarcinoma","volume":"76","author":"Ramacciato G.","year":"2010","journal-title":"Am. 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