Lv Tian-Run, Wang Ju-Mei, Ma Wen-Jie, Hu Ya-Fei, Dai Yu-Shi, Jin Yan-Wen, Li Fu-Yu
Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Oncol. 2022 Dec 12;12:1042493. doi: 10.3389/fonc.2022.1042493. eCollection 2022.
To evaluate the consistencies and inconsistencies between distal cholangiocarcinoma (DCCA) and pancreatic ductal adenocarcinoma (PDCA) regarding their biological features and long-term prognosis.
PubMed, the Cochrane Library, and EMBASE were searched to find comparative studies between DCCA and PDCA. RevMan5.3 and Stata 13.0 software were used for the statistical analyses.
Eleven studies with 4,698 patients with DCCA and 100,629 patients with PDCA were identified. Pooled results indicated that patients with DCCA had a significantly higher rate of preoperative jaundice (p = 0.0003). Lymphatic metastasis (p < 0.00001), vascular invasion (p < 0.0001), and peri-neural invasion (p = 0.005) were more frequently detected in patients with PDCA. After curative pancreaticoduodenectomy (PD), a significantly higher R0 rate (p < 0.0001) and significantly smaller tumor size (p < 0.00001) were detected in patients with DCCA. Patients with DCCA had a more favorable overall survival (OS) (p < 0.00001) and disease-free survival (DFS) (p = 0.005) than patients with PDCA. However, postoperative morbidities (p = 0.02), especially postoperative pancreatic fistula (POPF) (p < 0.00001), more frequently occurred in DCCA.
Patients with DCCA had more favorable tumor pathological features and long-term prognosis than patients with PDCA. An early diagnosis more frequently occurred in patients with DCCA. However, postoperative complications, especially POPF, were more frequently observed in patients with DCCA.
评估远端胆管癌（DCCA）与胰腺导管腺癌（PDCA）在生物学特征和长期预后方面的一致性与不一致性。
检索PubMed、Cochrane图书馆和EMBASE以查找DCCA与PDCA之间的比较研究。使用RevMan5.3和Stata 13.0软件进行统计分析。
共纳入11项研究，涉及4698例DCCA患者和100629例PDCA患者。汇总结果表明，DCCA患者术前黄疸发生率显著更高（p = 0.0003）。PDCA患者更常检测到淋巴结转移（p < 0.00001）、血管侵犯（p < 0.0001）和神经周围侵犯（p = 0.005）。在根治性胰十二指肠切除术（PD）后，DCCA患者的R0切除率显著更高（p < 0.0001），肿瘤大小显著更小（p < 0.00001）。与PDCA患者相比，DCCA患者的总生存期（OS）（p < 0.00001）和无病生存期（DFS）（p = 0.005）更优。然而，DCCA患者术后并发症（p = 0.02），尤其是术后胰瘘（POPF）（p < 0.00001）的发生率更高。
与PDCA患者相比，DCCA患者具有更优的肿瘤病理特征和长期预后。DCCA患者更常出现早期诊断。然而，DCCA患者术后并发症，尤其是POPF的发生率更高。
