Evidence map›Paper›PMID 40622853›Full record

ArticleHepatology (Baltimore, Md.)2026

Liver resection with and without vascular resection versus transplantation for de novo perihilar cholangiocarcinoma.

Yawen Dong, Zhihao Li, Vanja Podrascanin, John E Eaton, Sumera I Ilyas, Gregory J Gores, Susanne G Warner, Tayyab S Diwan, David M Nagorney, Julie K Heimbach and 3 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology (Baltimore, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. [Klatskin tumors-differentiated surgical treatment].Chirurgie (Heidelberg, Germany) · 2026
    Review
  4. Present and future of liver transplantation for cholangiocellular carcinoma: moving toward personalized multiparametric transplantability patterns.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yawen DongDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-3631-1228
Zhihao LiDivision of Transplantation Surgery, Department of Surgery, William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-5654-7043
Vanja PodrascaninDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
John E EatonDivision of Gastroenterology and Hepatology, Mayo Clinic, Department of Internal Medicine, Rochester, Minnesota, USA.
Sumera I IlyasDivision of Gastroenterology and Hepatology, Mayo Clinic, Department of Internal Medicine, Rochester, Minnesota, USA.ORCID 0000-0002-2709-3003
Gregory J GoresDivision of Gastroenterology and Hepatology, Mayo Clinic, Department of Internal Medicine, Rochester, Minnesota, USA.ORCID 0000-0003-3151-009
Susanne G WarnerDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0003-4329-7943
Tayyab S DiwanDivision of Transplantation Surgery, Department of Surgery, William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-4153-4469
David M NagorneyDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Julie K HeimbachDivision of Transplantation Surgery, Department of Surgery, William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-3567-1328
Rory L SmootDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0001-8543-661
Timucin TanerDivision of Transplantation Surgery, Department of Surgery, William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0003-0641-2930
Patrick P StarlingerDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-4666-5337

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe optimal treatment strategy for de novo perihilar cholangiocarcinoma (pCCA) remains debated. This study compares outcomes between liver transplantation following neoadjuvant chemoradiation (RT+LT) and liver resection (LR), with (LR+VR) and without vascular resection (LR w/o VR). APPROACH AND

resultsThis single-center, retrospective study included patients with de novo perihilar cholangiocarcinoma treated at the Mayo Clinic Rochester (1993-2023) with curative-intent surgery. Patients underwent either (1) LR, classified as LR+VR or LR w/o VR, or (2) RT+LT following the transplant protocol. Overall survival (OS) and recurrence-free survival were analyzed using as-treated and intention-to-treat approaches, incorporating competing risk analysis and direct matching. In the as-treated analysis, RT+LT showed superior median OS compared with LR w/o VR (78.0 vs. 58.2 mo, p =0.03) and LR+VR (25.8 mo, p <0.001). Considering dropout rates (RT+LT: 41%, LR: 28%), intention-to-treat analysis showed no significant OS difference between LR and RT + LT (31.7 vs. 38.5 mo, p =0.19). In matched as-treated analysis, RT + LT had no significant survival benefit over LR w/o VR (50.6 vs. 140.6 mo, p =0.08) or LR+VR (25.8 mo, p =0.11). Perioperative mortality was 4% (RT+LT), 7% (LR w/o VR), and 8% (LR + VR).

conclusionsBoth LR and RT+LT achieve excellent oncological outcomes in selected patients with de novo perihilar cholangiocarcinoma. Key challenges remain dropouts during neoadjuvant therapy in patients planned for LT and high perioperative mortality for patients undergoing LR. OS doubles in patients undergoing LR+VR compared with dropouts, supporting LR+VR as a viable option for patients who are ineligible for LT. Appropriate patient selection is crucial, as those not undergoing surgery suffer from a dismal prognosis.

Indexed as

Bile Duct NeoplasmsHepatectomyKlatskin TumorLiver TransplantationAgedFemaleHumansMaleMiddle AgedNeoadjuvant TherapyRetrospective StudiesTreatment Outcomedropout ratesintention-to-treat analysisneoadjuvant chemoradiationsurvival outcomesvascular reconstruction

Identifiers

PMID40622853
PMCPMC13089817

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.