The consistencies and inconsistencies between distal cholangiocarcinoma and pancreatic ductal adenocarcinoma: A systematic review and meta-analysis

Lv, Tian-Run; Wang, Ju-Mei; Ma, Wen‐Jie; Hu, Ya-Fei; Dai, Yu-Shi; Jin, Yu; Li, Fuyu

doi:10.3389/fonc.2022.1042493

Cited by 3 publications

(5 citation statements)

References 41 publications

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“…Interestingly, dCCA had more favorable tumor pathological features and long-term prognosis than patients with PDAC. On the other hand, patients with dCCA suffer more frequently from postoperative complications and especially postoperative pancreatic fistula [79]. These findings further corroborate the idea that a correct differential diagnosis is crucial for addressing the best therapeutic strategies.…”

Section: Clinical Cluessupporting

confidence: 71%

Extrahepatic Distal Cholangiocarcinoma vs. Pancreatic Ductal Adenocarcinoma: Histology and Molecular Profiling for Differential Diagnosis and Treatment

Gkountakos

Martelli

Silvestris

et al. 2023

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) and distal cholangiocarcinoma (dCCA) are very aggressive tumors with a high mortality rate. Pancreas and distal bile ducts share a common embryonic development. Hence, PDAC and dCCA exhibit similar histological features that make a differential diagnosis during routine diagnostic practice challenging. However, there are also significant differences, with potential clinical implications. Even if PDAC and dCCA are generally associated with poor survival, patients with dCCA seem to present a better prognosis. Moreover, although precision oncology-based approaches are still limited in both entities, their most important targets are different and include alterations affecting BRCA1/2 and related genes in PDAC, as well as HER2 amplification in dCCA. Along this line, microsatellite instability represents a potential contact point in terms of tailored treatments, but its prevalence is very low in both tumor types. This review aims at defining the most important similarities and differences in terms of clinicopathological and molecular features between these two entities, also discussing the main theranostic implications derived from this challenging differential diagnosis.

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Section: Clinical Cluessupporting

confidence: 71%

Extrahepatic Distal Cholangiocarcinoma vs. Pancreatic Ductal Adenocarcinoma: Histology and Molecular Profiling for Differential Diagnosis and Treatment

Gkountakos

Martelli

Silvestris

et al. 2023

Cancers

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“…A lymphadenectomy along with the hepatoduodenal ligament combined with partial hepatectomy has been strongly recommended as the standard surgical procedures for patients with progressive GBC disease. A clear margin without residual disease microscopically or macroscopically has been proved to be closely-associated with improved survival than those with positive margin 3 , 9 , 12 – 14 , 17 , 36 , 44 , 46 , 48 , 49 , 52 , 73 , which was also validated in our synthetic results with an extremely significant P -value combined with a high level of risk of death in terms of univariate analysis (HR=2.90, P <0.00001) and multivariate analysis (HR=2.28, P <0.00001).…”

Section: Discussionmentioning

confidence: 99%

“…For example, some researchers indicated that an elevated preoperative CA199 level indicated worse prognosis in postsurgical GBC patients 9 – 11 . Some easily-ignored predictors, such as age 12 , 13 and the level of preoperative fibrinogen level 14 , have also been recommended but not fully evaluated. Just as our previous series indicated that the whole biliary tract was surrounded by dense neural network, it might serve as another potential metastatic route for GBC patients 15 and prognostic significance of peri-neural invasion has also been validated in numerous previous publications 16 – 18 .…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for resected cases with gallbladder carcinoma: a systematic review and meta-analysis

Lv,

Wang,

et al. 2024

International Journal of Surgery

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Objective: Current meta-analysis was performed to systematically evaluate the potential prognostic factors for overall survival (OS) among resected cases with gallbladder carcinoma (GBC). Methods: PubMed, EMBASE, and the Cochrane Library were systematically retrieved and hazard ratio (HR) and its 95% confidence interval (CI) were directly extracted from the original study or roughly estimated via Tierney’s method. Standard Parmar modifications were used to determine pooled HRs. Results: A total of 36 studies with 11502 cases were identified. Pooled results of univariate analyses indicated that advanced age (HR=1.02, P=0.00020), concurrent gallstone disease (HR=1.22, P=0.00200), elevated preoperative CA199 level (HR=1.93, P<0.00001), advanced T stage (HR=3.09, P<0.00001), lymph node metastasis (HR=2.78, P<0.00001), peri-neural invasion (HR=2.20, P<0.00001), lymph-vascular invasion (HR=2.37, P<0.00001), vascular invasion (HR=2.28, P<0.00001), poorly differentiated tumor (HR=3.22, P<0.00001), hepatic side tumor (HR=1.85, P<0.00001), proximal tumor (neck/cystic duct) (HR=1.78, P<0.00001), combined bile duct resection (HR=1.45, P<0.00001), and positive surgical margin (HR=2.90, P<0.00001) were well-established prognostic factors. Pathological subtypes (P=0.53000) and postoperative adjuvant chemotherapy (P=0.70000) were not prognostic factors. Pooled results of multi-variate analyses indicated that age, gallstone disease, preoperative CA199, T stage, lymph node metastasis, peri-neural invasion, lymph-vascular invasion, tumor differentiation status, tumor location (peritoneal side vs hepatic side), surgical margin, combined bile duct resection, and postoperative adjuvant chemotherapy were independent prognostic factors. Conclusion: Various prognostic factors have been identified beyond the 8th AJCC staging system. By incorporating these factors into a prognostic model, a more individualized prognostication and treatment regime would be developed. Upcoming multinational studies are required for the further refine and validation.

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“…[15][16][17] Moreover, due to the inherent operational reasons of this examination method, many patients' feelings of pain during the examination lead to many problems with their actual situation. [18][19][20][21] PDCA management mode is a new management concept proposed by a management expert in the United States, Dai Ming. It mainly includes 4 steps, namely, P (plan), D (implementation), C (inspection), and A (treatment).…”

Section: Discussionmentioning

confidence: 99%

“…[15–17] Moreover, due to the inherent operational reasons of this examination method, many patients’ feelings of pain during the examination lead to many problems with their actual situation. [18–21]…”

Section: Discussionmentioning

confidence: 99%

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

Xu,

Shi,

Liu

2023

Medicine

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To explore the application effect of plan, do, check, action (PDCA) cycle on nursing quality management and risk control in digestive endoscope room. Ninety patients who received digestive endoscopy care before undergoing PDCA circulation mode risk control from January 2022 to April 2022 were selected as the Common group. From May 2022 to December 2022, 156 patients who underwent digestive endoscopy care after undergoing PDCA cycle mode risk control were selected as the PDCA group. Compare the infection status of patients in the endoscope room and the qualification of the air in the endoscope room before and after PDCA circulation management. Compare the respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, and nursing satisfaction of patients in the Common group and the PDCA group. Compare the qualified rate of endoscopic cavity disinfection before and after PDCA cycle management, the qualified rate of endoscopic external disinfection, and the management score. Four patients in the Common group developed infection, with an infection rate of 4.44%. One case of infection occurred in the PDCA group, with an infection rate of 0.64%. The qualified rate of the endoscope room air in the Common group was 92.22%, while the qualified rate of the endoscope room air in the PDCA group was 98.72%. Compared with the Common group, the infection rate of patients in the PDCA group significantly decreased, and the qualified rate of air in the endoscope room significantly increased. The respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, nursing errors, and nursing complaint rates of patients in the PDCA group were significantly lower than those in the Common group, and nursing satisfaction was significantly higher than those in the Common group. The qualified rate of endoscopic cavity disinfection and endoscopic external disinfection in the PDCA group were significantly higher than those in the Common group. Compared with before management, the scores of post management, nursing safety, disinfection and isolation, instruments, theoretical tests, and operational tests of nursing personnel after management increased significantly. The PDCA cycle is well applied in nursing quality management and risk control in the digestive endoscope room.

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The consistencies and inconsistencies between distal cholangiocarcinoma and pancreatic ductal adenocarcinoma: A systematic review and meta-analysis

Cited by 3 publications

References 41 publications

Extrahepatic Distal Cholangiocarcinoma vs. Pancreatic Ductal Adenocarcinoma: Histology and Molecular Profiling for Differential Diagnosis and Treatment

Extrahepatic Distal Cholangiocarcinoma vs. Pancreatic Ductal Adenocarcinoma: Histology and Molecular Profiling for Differential Diagnosis and Treatment

Prognostic factors for resected cases with gallbladder carcinoma: a systematic review and meta-analysis

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

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