Evidence map›Paper›PMID 40200911›Full record

ArticleBJS open2025

Western and Eastern experience in treating perihilar cholangiocarcinoma: retrospective bi-centre study.

Hannes Jansson, Atsushi Oba, Aya Maekawa, Christina Villard, Kosuke Kobayashi, Yoshihiro Ono, Jennie Engstrand, Fumihiro Kawano, Hiromichi Ito, Stefan Gilg and 3 more

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in BJS open, 2025. 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
–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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

13 authors.

Hannes JanssonDivision of Surgery and Oncology, Department of Clinical Science, Innovation and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1833-854X
Atsushi ObaDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.ORCID 0000-0002-7315-0830
Aya MaekawaDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Christina VillardDivision of Transplantation Surgery, Department of Clinical Science, Innovation and Technology, Karolinska Institutet, Stockholm, Sweden.
Kosuke KobayashiDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Yoshihiro OnoDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Jennie EngstrandDivision of Surgery and Oncology, Department of Clinical Science, Innovation and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-1123-7022
Fumihiro KawanoDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Hiromichi ItoDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.ORCID 0000-0003-0941-2055
Stefan GilgDivision of Surgery and Oncology, Department of Clinical Science, Innovation and Technology, Karolinska Institutet, Stockholm, Sweden.
Yosuke InoueDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Melroy A D'SouzaDivision of Surgery and Oncology, Department of Clinical Science, Innovation and Technology, Karolinska Institutet, Stockholm, Sweden.
Yu TakahashiDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.ORCID 0000-0003-3066-023X

Funding

Karolinska Institutet Hirsch FellowshipSweden-Japan FoundationSwedish Society of Medicine
6 · The paper itself

Abstract

backgroundResection outcomes for perihilar cholangiocarcinoma differ between Western and Eastern centres, but reasons behind these disparities remain unclear. This study aimed to compare current outcomes between a Western and an Eastern expert centre to identify prognostic factors.

methodsPatients who underwent hepatobiliary resection for perihilar cholangiocarcinoma between 2010 and 2022 at Karolinska University Hospital (Stockholm, Sweden) and Cancer Institute Hospital (Tokyo, Japan) were retrospectively included. Primary outcome was overall survival. Secondary outcomes were disease-free survival, postoperative complications and 90-day mortality rate.

resultsTwo hundred and forty-nine patients were included (Cancer Institute Hospital n = 159, Karolinska n = 90). Median overall survival was 20.4 months at Karolinska and 52.0 months at Cancer Institute Hospital (P < 0.001). Median disease-free survival was 11.9 months at Karolinska and 32.4 months at Cancer Institute Hospital (P < 0.001). Advanced tumours, ASA class ≥III, poor differentiation and radial margin positivity were more common in the Western cohort. Treatment centre, T-status, N1-status, resection side, R1-status, age and carbohydrate antigen 19-9 were prognostic for overall survival. The Eastern cohort had a lower rate of postoperative complications (24.5%) and a lower mortality rate (2.5%) compared with the Western cohort (51.1% and 10.0%).

conclusionAdvanced tumour stage and radial margin positivity contributed to poor long-term survival in the Western cohort. A higher burden of co-morbidity and a higher rate of extended resections with smaller remnant liver volume influenced the Western postoperative mortality rate.

Indexed as

Bile Duct NeoplasmsHepatectomyKlatskin TumorAgedDisease-Free SurvivalFemaleHumansJapanMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesSwedenTreatment Outcome

Identifiers

PMID40200911
PMCPMC11979329

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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.