Abstract
To assess the available evidence on the prognostic factors for the 5-year survival for patients with distal cholangiocarcinoma (DCC) following surgical resection. We performed a comprehensive search of abstracts included in databases where relevant studies were published between January 2000 and August 2015. Risk ratios (RRs), 95% confidence intervals (95% CIs), and random-effects model were calculated using RevMan 5.3 software. A total of 23 observational studies involving 2063 patients with DCC were analyzed. The meta-analysis showed that postoperative adjuvant chemotherapy was not confirmed as a prognostic factor, with similar 5-year survival rates between those receiving and not receiving chemotherapy (RR 0.71; 95% CI 0.21-2.36; P=0.57). Perineural invasion (RR 0.51; 95% CI 0.40-0.64; P<0.00001), lymph node metastasis (RR 0.51; 95% CI 0.38-0.70; P<0.0001), positive resection margin status (RR 2.11; 95% CI 1.36-3.30; P=0.001), and not-well-differentiated adenocarcinoma (RR 1.77; 95% CI 1.39-2.25; P<0.00001) were associated with shorter survival. Perineural invasion, lymph node metastasis, resection margin status, and tumor differentiation were the significant prognostic factors for the 5-year survival.
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