Evidence map›Paper›PMID 35752725›Full record

SynthesisAnnals of surgical oncology2022

Does Intraoperative Frozen Section and Revision of Margins Lead to Improved Survival in Patients Undergoing Resection of Perihilar Cholangiocarcinoma? A Systematic Review and Meta-analysis.

Tori Lenet, Richard W D Gilbert, Rory Smoot, Ching-Wei D Tzeng, Flavio G Rocha, Lavanya Yohanathan, Sean P Cleary, Guillaume Martel, Kimberly A Bertens

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.1field-weighted citation impact, top 8% of its field
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. [Frozen sections in hepatobiliary surgery].Chirurgie (Heidelberg, Germany) · 2025
    Review
  5. Article
  6. Article
  7. Article
  8. Review
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

9 authors at 6 institutions in 2 countries.

Tori LenetLiver and Pancreas Surgical Unit, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Richard W D GilbertLiver and Pancreas Surgical Unit, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Rory SmootDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Ching-Wei D TzengDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Flavio G RochaDivision of Surgical Oncology, Oregon Health and Science University/Knight Cancer Institute, Portland, OR, USA.
Lavanya YohanathanDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Sean P ClearyDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Guillaume MartelLiver and Pancreas Surgical Unit, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Kimberly A BertensLiver and Pancreas Surgical Unit, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. kbertens@toh.ca.
Mayo Clinic in Arizona · USOttawa Hospital Research InstituteOregon Health & Science University · USOttawa Hospital · CAThe University of Texas MD Anderson Cancer Center · USUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerihilar cholangiocarcinoma (PHC) is a rare malignancy that arises at the biliary confluence. Achieving a margin-negative resection (R0) is challenging given the anatomic location of tumors and remains the most important prognostic indicator of long-term survival. The objective of this study is to review the impact of intraoperative revision of positive biliary margins in PHC on oncologic outcomes. PATIENTS AND

methodsElectronic databases were searched from inception to October 2021. Studies comparing three types of patients undergoing resection of PHC with intraoperative frozen section of the proximal and/or distal bile ducts were identified: those who were margin-negative (R0), those with an initially positive margin who had revised negative margins (R1R0), and those with a persistently positive margin with or without revision of a positive margin (R1). The primary outcome was overall survival (OS). Secondary outcomes included risk of postoperative complication.

resultsA total of 449 studies were screened. Ten retrospective observational studies reporting on 1955 patients were included. Patients undergoing successful revision of a positive proximal and/or distal bile duct margin (R1R0) had similar OS to those with a primary margin-negative resection (R0) [hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.72-1.19, p = 0.56, I

conclusionsThis review supports routine intraoperative biliary margin evaluation during resection of PHC with revision if technically feasible.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaKlatskin TumorFrozen SectionsHumansMargins of ExcisionNeoplasm Recurrence, LocalRetrospective Studies

Identifiers

PMID35752725
OpenAlexW4283453934

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.