Annals of surgical oncology · 2026
Impact of Additional Resection on Outcomes in Patients with Positive Proximal Margin of Perihilar Cholangiocarcinoma: A Systematic Review and Network Meta-analysis.
СтатьяСистематический обзорNetwork Meta-AnalysisНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yang Dong-Liang, Ruan Hao-Tian, Shan Si-Qiao, Yuan Xue-Li, Yang Chang-Zhen, Zhang Tao, Lin Ming-Yu, Li Jing-Jing, Jia Bo, Yan Xiang-Yu, Zheng Lin-Lin, Zhao Zhi-Hao, Xiang Can-Hong, Li Li, Zeng Jian-Ping, Wang Si-Yuan, Jiang Nan, Jin Shuo
Аннотация
PURPOSE: We aimed to assess the impact of additional proximal margin (PM) resection on survival outcomes in patients with perihilar cholangiocarcinoma (pCCA) with intraoperative PM R1.
METHODS: MEDLINE, Cochrane, Embase, and Web of Science databases were systematically searched from inception to November 2024. Studies that compared survival outcomes among three patient groups were included. Patient groups were those with primary PM R0 resection, those who underwent additional resection to achieve secondary R0 (PM R1R0), and those with final PM R1. The primary outcome was overall survival (OS).
RESULTS: A total of 2419 studies were screened. Eight studies were finally enrolled in this meta-analysis, including 157 patients in the PM R1R0 group, 296 patients in the final R1 group, and 976 patients in the primary R0 group. Patients who achieved PM R1R0 through additional resection demonstrated significantly worse survival than those with primary R0 resection (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.54-0.80). Moreover, their survival outcomes were no different from those with final R1 margins (HR 0.82; 95% CI 0.63-1.06).
CONCLUSIONS: The current data showed that additional PM resection does not provide statistically significant survival benefits for pCCAs with intraoperative PM R1. The clinical application of additional resection in these patients needs further validation and investigation.
METHODS: MEDLINE, Cochrane, Embase, and Web of Science databases were systematically searched from inception to November 2024. Studies that compared survival outcomes among three patient groups were included. Patient groups were those with primary PM R0 resection, those who underwent additional resection to achieve secondary R0 (PM R1R0), and those with final PM R1. The primary outcome was overall survival (OS).
RESULTS: A total of 2419 studies were screened. Eight studies were finally enrolled in this meta-analysis, including 157 patients in the PM R1R0 group, 296 patients in the final R1 group, and 976 patients in the primary R0 group. Patients who achieved PM R1R0 through additional resection demonstrated significantly worse survival than those with primary R0 resection (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.54-0.80). Moreover, their survival outcomes were no different from those with final R1 margins (HR 0.82; 95% CI 0.63-1.06).
CONCLUSIONS: The current data showed that additional PM resection does not provide statistically significant survival benefits for pCCAs with intraoperative PM R1. The clinical application of additional resection in these patients needs further validation and investigation.