Evidence map›Paper›PMID 42142218›Full record

SynthesisJournal of gastrointestinal cancer2026

Long-term Outcomes of Protocol-based Neoadjuvant Selection and Liver Transplantation Versus Liver Resection for Perihilar Cholangiocarcinoma: A Systematic Review and Meta-analysis.

Mohamed Ali Chaouch, Jean Marc Bigourdan, Stylianos Tzedakis, Adriano Carneiro da Costa, Christoph Reissfelder, Wahid Fattal, Hani Oweira, Heithem Jeddou

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Journal of gastrointestinal cancer, 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

8 authors.

Mohamed Ali ChaouchDepartment of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia. docmedalichaouch@gmail.com.
Jean Marc BigourdanDepartment of Visceral and Digestive Surgery, Perpignan Hospital, Perpignan, France.
Stylianos TzedakisDepartment of Digestive, Pancreatic, Hepatobiliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hopitaux de Paris (AP- HP), Paris, France.
Adriano Carneiro da CostaDepartment of Surgery, Hospital of Clinics, Federal University of Pernambuco, Recife, PE, Brazil.
Christoph ReissfelderDepartment of Surgery, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Wahid FattalDepartment of Surgery, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Hani OweiraDepartment of Surgery, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Heithem JeddouDepartment of Hepatobiliary and Digestive Surgery, University Hospital, Rennes 1 University, Rennes, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerihilar cholangiocarcinoma (CCA) is an aggressive malignancy that presents significant challenges in terms of diagnosis and treatment owing to its anatomical location. Liver resection and transplantation are the primary curative options; however, their long-term outcomes remain controversial. This study aimed to compare the long-term outcomes of protocol-based neoadjuvant selection and liver transplantation with liver resection for the management of perihilar cholangiocarcinoma.

methodsA systematic review and meta-analysis were conducted according to the PRISMA guidelines. Electronic databases, including the Cochrane Library, PubMed/MEDLINE, and Embase, were searched for relevant clinical trials comparing liver transplantation with liver resection.

resultsSix studies comprising 768 patients (265 in the liver transplantation group and 503 in the liver resection group) were included. Liver transplantation was associated with significantly higher 5-year overall survival and 5-year disease-free survival. They also showed a higher 3-year disease-free survival rate. Patients in the liver transplantation group had a higher R0 resection rate. There were no significant differences in the 3- or 30-day postoperative mortality between the two groups.

conclusionLiver transplantation was associated with improved long-term survival in highly selected patients; however, these findings are limited by significant selection bias and the retrospective study design. The apparent long-term benefit observed with LT must be interpreted cautiously because transplant series frequently report post-transplant rather than intention-to-treat outcomes.

Indexed as

Bile Duct NeoplasmsHepatectomyKlatskin TumorLiver TransplantationNeoadjuvant TherapyDisease-Free SurvivalHumansPatient SelectionSurvival RateTreatment OutcomeLiver resectionLiver transplantationLong-term outcomesPerihilar cholangiocarcinomaR0 resectionSurvival rates

Identifiers

PMID42142218

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.