Treatment and Prognosis for Patients With Intrahepatic Cholangiocarcinoma

作者：Michael N. Mavros, Konstantinos P. Economopoulos, Vangelis G. Alexiou, Timothy Michael Pawlik · 发表于：JAMA Surgery · 年份：2014 · DOI：10.1001/jamasurg.2013.5137 · 被引用次数：833 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Gallbladder and Bile Duct Disorders、Pancreatic and Hepatic Oncology Research

IMPORTANCE: Data on outcomes following surgical management of intrahepatic cholangiocarcinoma (ICC) are limited. The incidence of ICC is increasing and it has a poor prognosis. No consensus has been reached regarding the optimal treatment modalities. OBJECTIVE: To systematically review and synthesize the available evidence regarding treatment and prognosis in patients with ICC. DATA SOURCES: The PubMed database was searched for relevant articles published between January 1, 2000, and April 1, 2013. STUDY SELECTION: Only studies assessing predictors of survival or recurrence in patients undergoing curative-intent surgical treatment of ICC were included. Small series, studies reporting on mixed types of cholangiocarcinoma, or exclusively on hepatolithiasis-associated cholangiocarcinoma, and those published in a language other than English, French, German, Italian, or Greek, were excluded. Fifty-seven of 960 articles were therefore analyzed. DATA EXTRACTION AND SYNTHESIS: Data on preoperative, intraoperative, and postoperative variables were extracted by 3 independent reviewers. Multiple studies reporting on the same population were excluded. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES: We hypothesized that preoperative variables and tumor characteristics affect patient survival. The outcomes of the study were overall survival and recurrence-free survival. The hypothesis was formulated before data collection. RESULTS: Fifty-seven studies (4756 patie...