Journal
SURGERY TODAY
Volume 47, Issue 3, Pages 271-279Publisher
SPRINGER
DOI: 10.1007/s00595-016-1362-0
Keywords
Distal cholangiocarcinoma; Meta-analysis; Prognostic factors
Categories
Funding
- German Research Council (DFG) [WE5085/1-1]
- Scientific Research Fund from Hubei University of Chinese Medicine
- Education Project of Medical Talents for Young and Middle-aged in Wuhan City [Q2014037]
- Young Talents Project of Science and Technology Research Program from Hubei Provincial Department of Education [Q20132003]
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To assess the available evidence on the prognostic factors for the 5-year survival for patients with distal cholangiocarcinoma (DCC) following surgical resection. We performed a comprehensive search of abstracts included in databases where relevant studies were published between January 2000 and August 2015. Risk ratios (RRs), 95 % confidence intervals (95 % CIs), and random-effects model were calculated using RevMan 5.3 software. A total of 23 observational studies involving 2063 patients with DCC were analyzed. The meta-analysis showed that postoperative adjuvant chemotherapy was not confirmed as a prognostic factor, with similar 5-year survival rates between those receiving and not receiving chemotherapy (RR 0.71; 95 % CI 0.21-2.36; P = 0.57). Perineural invasion (RR 0.51; 95 % CI 0.40-0.64; P < 0.00001), lymph node metastasis (RR 0.51; 95 % CI 0.38-0.70; P < 0.0001), positive resection margin status (RR 2.11; 95 % CI 1.36-3.30; P = 0.001), and not-well-differentiated adenocarcinoma (RR 1.77; 95 % CI 1.39-2.25; P < 0.00001) were associated with shorter survival. Perineural invasion, lymph node metastasis, resection margin status, and tumor differentiation were the significant prognostic factors for the 5-year survival.
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