Evidence map›Paper›PMID 37392289›Full record

ArticleLangenbeck's archives of surgery2023

Safety and efficacy of neoadjuvant chemotherapy based on our resectability criteria for locally advanced perihilar cholangiocarcinoma.

Kazuyuki Gyoten, Naohisa Kuriyama, Koki Maeda, Takahiro Ito, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Akihiro Tanemura, Yasuhiro Murata, Masashi Kishiwada and 1 more

Abstract read
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In one paragraph

Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

  1. Review
  2. Changing concepts in perihilar cholangiocarcinoma resections and surgery.International journal of surgery (London, England) · 2026
    Article
  3. Article
  4. [Frozen sections in hepatobiliary surgery].Chirurgie (Heidelberg, Germany) · 2025
    Review
  5. Article
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

11 authors.

Kazuyuki GyotenDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Naohisa KuriyamaDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. naokun@med.mie-u.ac.jp.
Koki MaedaDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Takahiro ItoDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Aoi HayasakiDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Takehiro FujiiDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Yusuke IizawaDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Akihiro TanemuraDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Yasuhiro MurataDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Masashi KishiwadaDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Shugo MizunoDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeoadjuvant chemotherapy (NAC) is not commonly used for perihilar cholangiocarcinoma (PHC). This study evaluated the safety and efficacy of NAC for PHC.

methodsNinety-one PHC patients without metastases were treated at our department. Patients were classified as resectable (R), borderline resectable (BR), or locally advanced unresectable (LA). Upfront surgery (US) was performed for R-PHC patients without regional lymph node metastases (LNM) or those unable to tolerate NAC. The NAC regimen comprised two courses of gemcitabine-based chemotherapy for advanced PHC: R-PHC with LNM, BR, and LA.

resultsUS and NAC were performed on 32 and 59 patients, respectively. For US, 31 patients underwent curative intent surgery (upfront-CIS). NAC caused adverse effects in 10/59 (17%), allowed 36/59 (61%) to undergo curative intent surgery (NAC-CIS) without impairing liver function, and spared 23/59 (39%) from undergoing resection (NAC-UR). Overall survival was better in the upfront-CIS and NAC-CIS groups than in the NAC-UR group (MST: 74 vs 57 vs 17 months, p < 0.001). In 59 NAC patients, tumour size response occurred in 11/11 (100%) of R, 22/33 (66.7%) of BR, and 9/15 (60.0%) of LA patients. The un-resection rate was the highest in the LA group (27% [3/11] than in R, 30% [10/33] in BR, and 67% [10/15] in LA, p = 0.039). Multivariate analyses revealed that LA and age were independent risk factors for non-resection after NAC.

conclusionwas safe and contributed to improving survival in advanced PHC patients. R-PHC was responsive to NAC, but LA remains a risk factor for non-resection through NAC.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaKlatskin TumorBile Ducts, IntrahepaticHumansNeoadjuvant TherapyGemcitabineNeoadjuvant chemotherapyPerihilar cholangiocarcinomaResectabilityUpfront surgery

Identifiers

PMID37392289

What OpenQuestion holds

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Registered trials

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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.