Impact of time-to-surgery on outcomes of patients undergoing curative-intent liver resection for BCLC-0, A and B hepatocellular carcinoma
| Autor: | Fabio Bagante, Olivier Soubrane, Itaru Endo, Aklile Workneh, Guillaume Martel, Sorin Alexandrescu, Demetrios Moris, Francesca Ratti, Adrian Diaz, Irinel Popescu, Diamantis I. Tsilimigras, Hugo Marques, J. Madison Hyer, Thomas J. Hugh, Luca Aldrighetti, Vincent Lam, Alfredo Guglielmi, George A. Poultsides, Timothy M. Pawlik |
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| Přispěvatelé: | Tsilimigras, D. I., Hyer, J. M., Diaz, A., Moris, D., Bagante, F., Ratti, F., Marques, H. P., Soubrane, O., Lam, V., Poultsides, G. A., Popescu, I., Alexandrescu, S., Martel, G., Workneh, A., Guglielmi, A., Hugh, T., Aldrighetti, L., Endo, I., Pawlik, T. M. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
time-to-surgery medicine.medical_specialty Carcinoma Hepatocellular Databases Factual Hepatocellular carcinoma medicine.medical_treatment liver Gastroenterology Time-to-Treatment Resection Resectable Hepatocellular Carcinoma Internal medicine Time-to-surgery medicine Time to surgery Hepatectomy Humans resection Aged Neoplasm Staging Retrospective Studies Curative intent business.industry Hazard ratio Liver Neoplasms General Medicine hepatocellular carcinoma Middle Aged medicine.disease Confidence interval HCC CHBPT Survival Rate BCLC Oncology Liver Female Surgery business Follow-Up Studies |
| Popis: | Background: The impact of a prolonged time-to-surgery (TTS) among patients with resectable hepatocellular carcinoma (HCC) is not well defined. Methods: Patients who underwent curative-intent hepatectomy for BCLC-0, A and B HCC between 2000 and 2017 were identified using a multi-institutional database. The impact of prolonged TTS on overall survival (OS) and disease-free survival (DFS) was examined. Results: Among 775 patients who underwent resection for HCC, 537 (69.3%) had early surgery (TTS < 90 days) and 238 (30.7%) patients had a delayed surgery (TTS ≥ 90 days). Patient- and tumor-related characteristics were similar between the two groups except for a higher proportion of patients undergoing major liver resection in the early surgery group (31.3% vs. 23.8%, p = .04). The percentage of patients with delayed surgery varied from 8.8% to 59.1% among different centers (p < .001). Patients with TTS < 90 days had similar 5-year OS (63.7% vs. 64.9; p = .79) and 5-year DFS (33.5% vs. 42.4; p = .20) with that of patients with TTS ≥ 90 days. On multivariable analysis, delayed surgery was not associated with neither worse OS (BCLC-0/A: adjusted hazards ratio [aHR] = 0.90; 95% confidence interval [CI]: 0.65-1.25 and BCLC-B: aHR = 0.72; 95%CI: 0.30-1.74) nor DFS (BCLC-0/A: aHR = 0.78; 95%CI: 0.60-1.01 and BCLC-B: aHR = 0.67; 95% CI: 0.36-1.25). Conclusion: Approximately one in three patients diagnosed with resectable HCC had a prolonged TTS. Delayed surgery was not associated with worse outcomes among patients with resectable HCC. info:eu-repo/semantics/publishedVersion |
| Databáze: | OpenAIRE |
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