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.
OBJECTIVE: To evaluate the consistencies and inconsistencies between distal cholangiocarcinoma (DCCA) and pancreatic ductal adenocarcinoma (PDCA) regarding their biological features and long-term prognosis. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
目的：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。 方法：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。 结果：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。 结论：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。
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