Meta-analysis of prognostic factors for overall survival in patients with resected hilar cholangiocarcinoma
| العنوان: | Meta-analysis of prognostic factors for overall survival in patients with resected hilar cholangiocarcinoma |
|---|---|
| المؤلفون: | Robert Jones, G.J. Poston, Hassan Malik, James Dodd, A. McKenna, N. Bird |
| المصدر: | British Journal of Surgery. 105:1408-1416 |
| بيانات النشر: | Oxford University Press (OUP), 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Oncology, medicine.medical_specialty, medicine.medical_treatment, Perineural invasion, 030230 surgery, Global Health, Preoperative care, Cholangiocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Hepatectomy, Humans, Medicine, Lymph node, Neoplasm Staging, AJCC staging system, business.industry, Hazard ratio, Prognosis, Survival Rate, Bile Ducts, Intrahepatic, medicine.anatomical_structure, Bile Duct Neoplasms, 030220 oncology & carcinogenesis, Meta-analysis, Resection margin, Surgery, business |
| الوصف: | Background Hilar cholangiocarcinoma is staged using the AJCC staging system. Numerous other prognostically important histopathological and demographic characteristics have been reported. The objective of this meta-analysis was to assess statistically the effect of postresectional tumour characteristics on overall survival of patients undergoing attempted radical curative resection for hilar cholangiocarcinoma. Methods Relevant studies were identified by searching the Ovid MEDLINE and PubMed databases. The search was limited to studies published between 2009 and 2017. Papers referring to intrahepatic or distal cholangiocarcinoma were excluded from review. Data extraction used standard Parmar modifications to determine pooled univariable hazard ratios (HRs). Results Twenty-four articles, containing 4599 patients, were assessed quantitatively. In pooled analyses, age (HR 1·16, 95 per cent c.i. 1·04 to 1·28), T category (HR 1·49, 1·30 to 1·70), lymph node involvement (HR 1·78, 1·65 to 1·93), microvascular invasion (HR 1·49, 1·34 to 1·68), perineural invasion (HR 1·54, 1·40 to 1·68) and tumour differentiation (HR 1·54, 1·38 to 1·72) were significant prognostic factors, with low heterogeneity. Portal vein resection (HR 1·54, 1·15 to 1·70) and resection margin status (HR 1·77, 1·57 to 1·99) had significant effects, but with high heterogeneity. Sex, tumour size and preoperative carbohydrate antigen 19-9 levels did not have a statistically significant effect on postoperative prognosis. Conclusion Several tumour biological variables not included in the seventh edition of the AJCC classification affect overall survival. These require incorporation into prognostic models to ensure a personalized approach to prognostication and treatment. |
| تدمد: | 1365-2168 0007-1323 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::85c9d1ee82d99d86d20d29f483d56ac3 https://doi.org/10.1002/bjs.10921 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....85c9d1ee82d99d86d20d29f483d56ac3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13652168 00071323 |
|---|