Systematic review and meta-analysis of surgery for hilar cholangiocarcinoma with arterial resection.

Autor:	Rebelo A; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany. Electronic address: artur.rebelo@uk-halle.de., Friedrichs J; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Grilli M; Professional Information Biomedicine and Health Profession, Karlsruhe, Germany., Wahbeh N; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Partsakhashvili J; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Ukkat J; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Klose J; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Ronellenfitsch U; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany., Kleeff J; Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University, Halle-Wittenberg, Germany.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2022 Oct; Vol. 24 (10), pp. 1600-1614. Date of Electronic Publication: 2022 Apr 14.
DOI:	10.1016/j.hpb.2022.04.002
Abstrakt:	Background: With the advances in multimodality treatment, an analysis of the outcome of arterial resections (AR) in surgery of cholangiocarcinoma is lacking. The aim of this meta-analysis was to summarize the currently available evidence onof AR for the treatment of cholangiocarcinoma. Methods: A systematic literature search was carried out according to PRISMA guidelines. Results: 10 retrospective cohort studies published from 2007 to 2020 with 2530 patients (408 AR group and 2122 control group) were identified. Higher in-hospital mortality rates (6.8% vs 3.3%, OR 2.65, 95% CI [1.27; 5.32], p = 0.009), higher morbidity rates (Clavien-Dindo classification ≥3 ) (52% vs 47%, OR 1.44, 95% CI [1.02; 1.75], p = 0.04) and lower 1-year, 3-year and 5-year survival rates (54% vs 69%, OR 0.55, 95% CI [0.34; 0.91 p = 0.02), (34% vs 38%, OR 0.74, 95% CI [0.55; 0.98, p = 0.03), (18% vs 29%, OR 0.54, 95% CI [0.39; 0.75, p = 0.0002) were observed in the AR group when compared to the control group. Conclusion: Evidence from non-randomized studies shows a higher morbidity and mortality and shorter long-term survival in patients undergoing AR. However, the results are prone to selection bias, and only randomized trials comparing AR and palliative treatments AR might reveal a possible benefit of AR. Systematic Review Registration: PROSPERO ID 223396. (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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