Evidence map›Paper›PMID 38326854›Full record

ArticleWorld journal of surgical oncology2024

Preoperative predictors for non-resectability in perihilar cholangiocarcinoma.

Carlos Constantin Otto, Anna Mantas, Lara Rosaline Heij, Daniel Heise, Maxime Dewulf, Sven Arke Lang, Tom Florian Ulmer, Edgar Dahl, Philipp Bruners, Ulf Peter Neumann and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.6field-weighted citation impact, top 5% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. The Prognostic Value of the XPC rs2228001 Single Nucleotide Polymorphism in Cholangiocarcinoma.Liver international : official journal of the International Association for the Study of the Liver · 2025
    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 at 3 institutions in 2 countries.

Carlos Constantin OttoDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Anna MantasDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Lara Rosaline HeijDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Daniel HeiseDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Maxime DewulfDepartment of Surgery, Maastricht University Medical Center (MUMC), Maastricht, Netherlands.
Sven Arke LangDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Tom Florian UlmerDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Edgar DahlInstitute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
Philipp BrunersDepartment of Radiology, University Hospital RWTH Aachen, Aachen, Germany.
Ulf Peter NeumannDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
Jan BednarschDepartment of Surgery and Transplantation, University Hospital Essen, Essen, Germany. jan.bednarsch@uk-essen.de.
RWTH Aachen University · DEEssen University Hospital · DEMaastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionExplorative laparotomy without subsequent curative-intent liver resection remains a major clinical problem in the treatment of perihilar cholangiocarcinoma (pCCA). Thus, we aimed to identify preoperative risk factors for non-resectability of pCCA patients. MATERIAL AND

methodsPatients undergoing surgical exploration between 2010 and 2022 were eligible for the analysis. Separate binary logistic regressions analyses were used to determine risk factors for non-resectability after explorative laparotomy due to technical (tumor extent, vessel infiltration) and oncological (peritoneal carcinomatosis, distant nodal or liver metastases)/liver function reasons.

resultsThis monocentric cohort comprised 318 patients with 209 (65.7%) being surgically resected and 109 (34.3%) being surgically explored [explorative laparotomy: 87 (27.4%), laparoscopic exploration: 22 (6.9%)]. The median age in the cohort was 69 years (range 60-75) and a majority had significant comorbidities with ASA-Score ≥ 3 (202/318, 63.5%). Statistically significant (p < 0.05) risk factors for non-resectability were age above 70 years (HR = 3.76, p = 0.003), portal vein embolization (PVE, HR = 5.73, p = 0.007), and arterial infiltration > 180° (HR = 8.05 p < 0.001) for technical non-resectability and PVE (HR = 4.67, p = 0.018), arterial infiltration > 180° (HR = 3.24, p = 0.015), and elevated CA 19-9 (HR = 3.2, p = 0.009) for oncological/liver-functional non-resectability.

conclusionAdvanced age, PVE, arterial infiltration, and elevated CA19-9 are major risk factors for non-resectability in pCCA. Preoperative assessment of those factors is crucial for better therapeutical pathways. Diagnostic laparoscopy, especially in high-risk situations, should be used to reduce the amount of explorative laparotomies without subsequent liver resection.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaKlatskin TumorLaparoscopyAgedHepatectomyHumansLaparotomyMiddle AgedKlatskin tumorNon-resectabilityPeritoneal neoplasmsStaging laparoscopy

Identifiers

PMID38326854
PMCPMC10851609
OpenAlexW4391598478

What OpenQuestion holds

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LicenceCC BY
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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.