Hilar cholangiocarcinoma:a meta-analysis of 2280 cases / 中华肝胆外科杂志

ABSTRACT

Objective The aim of this study is to elucidate the current status of hilar cholangiocarcinoma with regard to its epidemiology,clinical features,diagnosis,Bismuth-Corlette typing,pathologic categories,treatment,complication and prognosis in China.Methods Original articles published form January 1991 to August 2008 were searched in the CBM disc,VIP information and CNKI.Clinical appraisal and data extraction were conducted independently by 2 reviewers.The outcomes of 2280 procedures from 22 retrospective studies were analyzed.Results When radical resection was compared with palliative resection,the 1-yr survival rate (84.0％ vs.46.8％,OR=5.71,95％CI 3.99～8.17,P＜0.01) and 3-yr survival rate (31.5％ vs.13.5％,OR=4.43,95％CI 2.07～9.47,P＜0.01) were significantly higher.For the palliative resection group,the 1-yr survival rate of the drainage group (27.2％ vs.38.7％,OR=0.47,95％CI 0.31～0.72,P＜0.01) was significantly higher than the palliative resection group.The rate of tumor resection rose after 2002 (x2=35.9588,P＜0.01),but the rate of radical resection did not significantly rise ((2 =2.1052,P=0.1468).Conclusions Radical resection is still the optimal treatment for hilar cholangiocarcinoma.If radical resection is technically not possible,palliative drainage is a reasonable treatment.Palliative resection do not improve survival and it is not recommended.