Evidence map›Paper›PMID 41688833›Full record

SynthesisAnnals of surgical oncology2026

Impact of Additional Resection on Outcomes in Patients with Positive Proximal Margin of Perihilar Cholangiocarcinoma: A Systematic Review and Network Meta-analysis.

Dong-Liang Yang, Hao-Tian Ruan, Si-Qiao Shan, Xue-Li Yuan, Chang-Zhen Yang, Tao Zhang, Ming-Yu Lin, Jing-Jing Li, Bo Jia, Xiang-Yu Yan and 8 more

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Dong-Liang Yang *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Hao-Tian Ruan *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Si-Qiao Shan *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Xue-Li Yuan *Department of Nursing, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Chang-Zhen YangHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Tao ZhangHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Ming-Yu LinDepartment of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun, China.
Jing-Jing LiDepartment of Nursing, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Bo JiaDepartment of Nursing, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Xiang-Yu YanHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Lin-Lin ZhengDepartment of Hepatobiliary Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Zhi-Hao ZhaoDepartment of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun, China.
Can-Hong XiangHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Li LiDepartment of Pathology, Beijing Tsinghua Changgung Hospital, Beijing, China.
Jian-Ping ZengHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Si-Yuan Wang *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Nan Jiang *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China.
Shuo Jin *Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology, Ministry of Education, School of Clinical Medicine, Tsinghua University, Beijing, China. jsa01263@163.com.ORCID http://orcid.org/0000-0001-9452-1912

Funding

Beijing Hospitals Authority Clinical Medicine Development of special funding support YGLX202329Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support Changgung Shuo Jin 202321Beijing Physician Scientist Training Project BJPSTP-2024-23Beijing Research Ward Excellence Program BRWEP2024W032240103Beijing Research Ward Excellence Program BRWEP2024W032240108National Natural Science Foundation of China No. 82090050National Natural Science Foundation of China No. 82090053National Natural Science Foundation of China No. 82090054National Natural Science Foundation of China - State Grid Corporation Joint Fund for Smart Grid No. 82027807Tsinghua University Initiative Scientific Research Program of Precision Medicine No. 10001020123Tsinghua University Initiative Scientific Research Program of Precision Medicine No. 2022TS014Young Elite Scientist Sponsorship program by Bast BYESS2023213
6 · The paper itself

Abstract

purposeWe aimed to assess the impact of additional proximal margin (PM) resection on survival outcomes in patients with perihilar cholangiocarcinoma (pCCA) with intraoperative PM R1.

methodsMEDLINE, Cochrane, Embase, and Web of Science databases were systematically searched from inception to November 2024. Studies that compared survival outcomes among three patient groups were included. Patient groups were those with primary PM R0 resection, those who underwent additional resection to achieve secondary R0 (PM R1R0), and those with final PM R1. The primary outcome was overall survival (OS).

resultsA total of 2419 studies were screened. Eight studies were finally enrolled in this meta-analysis, including 157 patients in the PM R1R0 group, 296 patients in the final R1 group, and 976 patients in the primary R0 group. Patients who achieved PM R1R0 through additional resection demonstrated significantly worse survival than those with primary R0 resection (hazard ratio [HR] 0.65; 95% confidence interval [CI] 0.54-0.80). Moreover, their survival outcomes were no different from those with final R1 margins (HR 0.82; 95% CI 0.63-1.06).

conclusionsThe current data showed that additional PM resection does not provide statistically significant survival benefits for pCCAs with intraoperative PM R1. The clinical application of additional resection in these patients needs further validation and investigation.

Indexed as

Bile Duct NeoplasmsKlatskin TumorMargins of ExcisionHumansPrognosisSurvival RateAdditional resectionNetwork meta-analysisOverall survivalPerihilar cholangiocarcinomaProximal margin

Identifiers

PMID41688833

What OpenQuestion holds

Textmetadata
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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.