Woo Jin Choi1,2, Phil J Williams1, Marco P A W Claasen2,3, Tommy Ivanics2,4,5, Marina Englesakis6, Steven Gallinger1,2, Bettina Hansen7, Gonzalo Sapisochin8,9. 1. Department of General Surgery, University of Toronto, Toronto, Canada. 2. Division of General Surgery, HPB Surgical Oncology, HBP and Multi Organ Transplant Program, University Health Network, University of Toronto, Toronto, Canada. 3. Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC Transplant Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands. 4. Department of Surgery, Henry Ford Hospital, Detroit, MI, USA. 5. Department of Surgical Sciences, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden. 6. Library and Information Services, University Health Network, Toronto, Canada. 7. Center for Liver Disease, University Health Network, Toronto, Canada. 8. Department of General Surgery, University of Toronto, Toronto, Canada. Gonzalo.sapisochin@uhn.ca. 9. Division of General Surgery, HPB Surgical Oncology, HBP and Multi Organ Transplant Program, University Health Network, University of Toronto, Toronto, Canada. Gonzalo.sapisochin@uhn.ca.
Abstract
BACKGROUND: Recurrence rates of intrahepatic cholangiocarcinoma (iCCA) after curative hepatectomy are as high as 50% to 70%, and about half of these recurrences occur within 2 years. This systematic review aims to define prognostic factors (PFs) for early recurrence (ER, within 24 months) and 24-month disease-free survival (DFS) after curative-intent iCCA resections. METHODS: Systematic searching was performed from database inception to 14 January 2021. Duplicate independent review and data extraction were performed. Data on 13 predefined PFs were collected. Meta-analysis was performed on PFs for ER and summarized using forest plots. The Quality in Prognostic Factor Studies tool was used for risk-of-bias assessment. RESULTS: The study enrolled 10 studies comprising 4158 patients during an accrual period ranging from 1990 to 2016. In the risk-of-bias assessment of patients who experienced ER after curative-intent iCCA resection, six studies were rated as low risk and four as moderate risk (49.6%; 95% confidence interval [CI], 49.2-50.0). Nine studies were pooled for meta-analysis. Of the postoperative PFs, multiple tumors, microvascular invasion, macrovascular invasion, lymph node metastasis, and R1 resection were associated with an increased hazard for ER or a reduced 24-month DFS, and the opposite was observed for receipt of adjuvant chemo/radiation therapy. Of the preoperative factors, cirrhosis, sex, HBV status were not associated with ER or 24-month DFS. CONCLUSION: The findings from this systematic review could allow for improved surveillance, prognostication, and treatment decision-making for patients with resectable iCCAs. Further well-designed prospective studies are needed to explore prognostic factors for iCCA ER with a focus on preoperative variables.
BACKGROUND: Recurrence rates of intrahepatic cholangiocarcinoma (iCCA) after curative hepatectomy are as high as 50% to 70%, and about half of these recurrences occur within 2 years. This systematic review aims to define prognostic factors (PFs) for early recurrence (ER, within 24 months) and 24-month disease-free survival (DFS) after curative-intent iCCA resections. METHODS: Systematic searching was performed from database inception to 14 January 2021. Duplicate independent review and data extraction were performed. Data on 13 predefined PFs were collected. Meta-analysis was performed on PFs for ER and summarized using forest plots. The Quality in Prognostic Factor Studies tool was used for risk-of-bias assessment. RESULTS: The study enrolled 10 studies comprising 4158 patients during an accrual period ranging from 1990 to 2016. In the risk-of-bias assessment of patients who experienced ER after curative-intent iCCA resection, six studies were rated as low risk and four as moderate risk (49.6%; 95% confidence interval [CI], 49.2-50.0). Nine studies were pooled for meta-analysis. Of the postoperative PFs, multiple tumors, microvascular invasion, macrovascular invasion, lymph node metastasis, and R1 resection were associated with an increased hazard for ER or a reduced 24-month DFS, and the opposite was observed for receipt of adjuvant chemo/radiation therapy. Of the preoperative factors, cirrhosis, sex, HBV status were not associated with ER or 24-month DFS. CONCLUSION: The findings from this systematic review could allow for improved surveillance, prognostication, and treatment decision-making for patients with resectable iCCAs. Further well-designed prospective studies are needed to explore prognostic factors for iCCA ER with a focus on preoperative variables.
Authors: John Bridgewater; Peter R Galle; Shahid A Khan; Josep M Llovet; Joong-Won Park; Tushar Patel; Timothy M Pawlik; Gregory J Gores Journal: J Hepatol Date: 2014-03-27 Impact factor: 25.083
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
Authors: Diamantis I Tsilimigras; Kota Sahara; Lu Wu; Dimitrios Moris; Fabio Bagante; Alfredo Guglielmi; Luca Aldrighetti; Matthew Weiss; Todd W Bauer; Sorin Alexandrescu; George A Poultsides; Shishir K Maithel; Hugo P Marques; Guillaume Martel; Carlo Pulitano; Feng Shen; Olivier Soubrane; B Groot Koerkamp; Amika Moro; Kazunari Sasaki; Federico Aucejo; Xu-Feng Zhang; Ryusei Matsuyama; Itaru Endo; Timothy M Pawlik Journal: JAMA Surg Date: 2020-09-01 Impact factor: 14.766