- 2026-02-13
- Annals of surgical oncology 33(5)
- Dong-Liang Yang
- Hao-Tian Ruan
- Si-Qiao Shan
- Xue-Li Yuan
- Chang-Zhen Yang
- Tao Zhang
- Ming-Yu Lin
- Jing-Jing Li
- Bo Jia
- Xiang-Yu Yan
- Lin-Lin Zheng
- Zhi-Hao Zhao
- Can-Hong Xiang
- Li Li
- Jian-Ping Zeng
- Si-Yuan Wang
- Nan Jiang
- Shuo Jin
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 2,419
- Population
- 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.
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.