• Br J Surg · Jun 2022

    Meta Analysis

    Repeat liver resection for recurrent intrahepatic cholangiocarcinoma: meta-analysis.

    • Ali Ramouz, Sadeq Ali-Hasan-Al-Saegh, Saeed Shafiei, Sanam Fakour, Elias Khajeh, Ali Majlesara, Ali Adeliansedehi, Pascal Probst, Christoph Springfeld, De-Hua Chang, Christian Rupp, Carlos Carvalho, Mohammad Golriz, Katrin Hoffmann, and Arianeb Mehrabi.
    • Department of General, Visceral, and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
    • Br J Surg. 2022 Jun 14; 109 (7): 580-587.

    BackgroundIntrahepatic cholangiocarcinoma (ICC) is a relatively rare malignancy. The aim of this meta-analysis was to evaluate outcomes of repeat liver resection and non-surgical approaches for treatment of recurrent ICC.MethodsPubMed, Embase, and Web of Science databases were searched from their inception until March 2021 for studies of patients with recurrent ICC. Studies not published in English were excluded. Two meta-analyses were performed: a single-arm meta-analysis of studies reporting pooled short- and long-term outcomes after repeat liver resection for recurrent ICC (meta-analysis A), and a meta-analysis of studies comparing 1-, 3-, and 5-year overall survival (OS) rates after repeat liver resection and non-surgical approaches for recurrent ICC (meta-analysis B).ResultsOf 543 articles retrieved in the search, 28 were eligible for inclusion. Twenty-four studies (390 patients) were included in meta-analysis A and nine studies (591 patients) in meta-analysis B. After repeat liver resection, 1-, 3-, and 5-year OS rates were 87 (95 per cent c.i. 81 to 91), 58 (48 to 68), and 39 (29 to 50) per cent respectively. The 1-, 3-, and 5-year OS rates were higher after repeat liver resection than without surgery: odds ratio 2.70 (95 per cent c.i. 1.28 to 5.68), 2.89 (1.15 to 7.27), and 5.91 (1.59, 21.90) respectively.ConclusionRepeat liver resection is a suitable strategy for recurrent ICC in selected patients. It improves short- and long-term outcomes compared with non-surgical treatments.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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