Evidence map›Paper›PMID 29404753›Full record

ArticleWorld journal of surgery2018

Defining Early Recurrence of Hilar Cholangiocarcinoma After Curative-intent Surgery: A Multi-institutional Study from the US Extrahepatic Biliary Malignancy Consortium.

Xu-Feng Zhang, Eliza W Beal, Jeffery Chakedis, Qinyu Chen, Yi Lv, Cecilia G Ethun, Ahmed Salem, Sharon M Weber, Thuy Tran, George Poultsides and 14 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Xu-Feng ZhangDepartment of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Eliza W BealDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Jeffery ChakedisDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Qinyu ChenDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Yi LvDepartment of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Cecilia G EthunDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Ahmed SalemDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Sharon M WeberDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Thuy TranDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
George PoultsidesDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
Andre Y SonDepartment of Surgery, New York University, New York, NY, USA.
Ioannis HatzarasDepartment of Surgery, New York University, New York, NY, USA.
Linda JinDepartment of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Stefan BuettnerDivision of Surgical Oncology, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
Charles ScogginsDivision of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY, USA.
Robert C G MartinDivision of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY, USA.
Chelsea A IsomDivision of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Kamron IdreesDivision of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Harveshp D MogalDepartment of Surgery, Wake Forest University, Winston-Salem, NC, USA.
Perry ShenDepartment of Surgery, Wake Forest University, Winston-Salem, NC, USA.
Shishir K MaithelDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Carl R SchmidtDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Timothy M PawlikDepartment of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA. tim.pawlik@osumc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTime to tumor recurrence may be associated with outcomes following resection of hepatobiliary cancers. The objective of the current study was to investigate risk factors and prognosis among patients with early versus late recurrence of hilar cholangiocarcinoma (HCCA) after curative-intent resection.

methodsA total of 225 patients who underwent curative-intent resection for HCCA were identified from 10 academic centers in the USA. Data on clinicopathologic characteristics, pre-, intra-, and postoperative details and overall survival (OS) were analyzed. The slope of the curves identified by linear regression was used to categorize recurrences as early versus late.

resultsWith a median follow-up of 18.0 months, 99 (44.0%) patients experienced a tumor recurrence. According to the slope of the curves identified by linear regression, the functions of the two straight lines were y = -0.465x + 16.99 and y = -0.12x + 7.16. The intercept value of the two lines was 28.5 months, and therefore, 30 months (2.5 years) was defined as the cutoff to differentiate early from late recurrence. Among 99 patients who experienced recurrence, the majority (n = 80, 80.8%) occurred within the first 2.5 years (early recurrence), while 19.2% of recurrences occurred beyond 2.5 years (late recurrence). Early recurrence was more likely present as distant disease (75.1% vs. 31.6%, p = 0.001) and was associated with a worse OS (Median OS, early 21.5 vs. late 50.4 months, p < 0.001). On multivariable analysis, poor tumor differentiation (HR 10.3, p = 0.021), microvascular invasion (HR 3.3, p = 0.037), perineural invasion (HR 3.9, p = 0.029), lymph node metastases (HR 5.0, p = 0.004), and microscopic positive margin (HR 3.5, p = 0.046) were independent risk factors associated with early recurrence.

conclusionsEarly recurrence of HCCA after curative resection was common (~35.6%). Early recurrence was strongly associated with aggressive tumor characteristics, increased risk of distant metastatic recurrence and a worse long-term survival.

Indexed as

Neoplasm Recurrence, LocalAdultAgedBile Duct NeoplasmsBiliary Tract NeoplasmsCholangiocarcinomaData CollectionFemaleHumansKlatskin TumorLymphatic MetastasisMaleMiddle AgedMultivariate AnalysisPrognosisRisk Factors

Identifiers

PMID29404753

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.