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Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates.

Publication ,  Journal Article
Ziogas, IA; Giannis, D; Economopoulos, KP; Hayat, MH; Montenovo, MI; Matsuoka, LK; Alexopoulos, SP
Published in: Transplantation
October 2021

Intrahepatic cholangiocarcinoma (iCCA) is a contraindication to liver transplantation in most centers worldwide. Therefore, only a few such cases have been performed in each individual center, and the need for a systematic review and meta-analysis to cumulatively pool these results is apparent.A systematic literature review was conducted using the MEDLINE and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (end-of-search date: May 29, 2020). Meta-analyses of proportions were conducted to pool the overall survival (OS), recurrence-free survival (RFS), and overall recurrence rates using the random-effects model. Meta-regression was used to examine cirrhosis and incidental diagnosis as confounders on OS and RFS.Eighteen studies comprising 355 patients and a registry study of 385 patients were included. The pooled 1-, 3-, and 5-y OS rates were 75% (95% CI, 64%-84%), 56% (95% CI, 46%-67%), and 42% (95% CI, 29%-55%), respectively. The pooled 1-, 3-, and 5-y RFS rates were 70% (95% CI, 63%-75%), 49% (95% CI, 41%-57%), and 38% (95% CI, 27%-50%), respectively. Cirrhosis was positively associated with RFS, while incidental diagnosis was not. Neither cirrhosis nor incidental diagnosis was associated with OS. The pooled overall recurrence rate was 43% (95% CI, 33%-53%) over a mean follow-up of 40.6 ± 37.7 mo. Patients with very early (single ≤2 cm) iCCA exhibited superior pooled 5-y RFS (67%; 95% CI, 47%-86%) versus advanced iCCA (34%; 95% CI, 23%-46%).Cirrhotics with very early iCCA or carefully selected patients with advanced iCCA after neoadjuvant therapy may benefit from liver transplantation under research protocols.

Duke Scholars

Published In

Transplantation

DOI

EISSN

1534-6080

ISSN

0041-1337

Publication Date

October 2021

Volume

105

Issue

10

Start / End Page

2263 / 2271

Related Subject Headings

  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Progression-Free Survival
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Liver Transplantation
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ziogas, I. A., Giannis, D., Economopoulos, K. P., Hayat, M. H., Montenovo, M. I., Matsuoka, L. K., & Alexopoulos, S. P. (2021). Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates. Transplantation, 105(10), 2263–2271. https://doi.org/10.1097/tp.0000000000003539
Ziogas, Ioannis A., Dimitrios Giannis, Konstantinos P. Economopoulos, Muhammad H. Hayat, Martin I. Montenovo, Lea K. Matsuoka, and Sophoclis P. Alexopoulos. “Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates.Transplantation 105, no. 10 (October 2021): 2263–71. https://doi.org/10.1097/tp.0000000000003539.
Ziogas IA, Giannis D, Economopoulos KP, Hayat MH, Montenovo MI, Matsuoka LK, et al. Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates. Transplantation. 2021 Oct;105(10):2263–71.
Ziogas, Ioannis A., et al. “Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates.Transplantation, vol. 105, no. 10, Oct. 2021, pp. 2263–71. Epmc, doi:10.1097/tp.0000000000003539.
Ziogas IA, Giannis D, Economopoulos KP, Hayat MH, Montenovo MI, Matsuoka LK, Alexopoulos SP. Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates. Transplantation. 2021 Oct;105(10):2263–2271.

Published In

Transplantation

DOI

EISSN

1534-6080

ISSN

0041-1337

Publication Date

October 2021

Volume

105

Issue

10

Start / End Page

2263 / 2271

Related Subject Headings

  • Time Factors
  • Surgery
  • Risk Factors
  • Risk Assessment
  • Progression-Free Survival
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Liver Transplantation
  • Humans