Perihilar Cholangiocarcinoma - Novel Benchmark Values for Surgical and Oncological Outcomes From 24 Expert Centers
Autor: | Camila Hidalgo-Salinas, Ryota Higuchi, Elissaios Kontis, Eva Breuer, Ho-Seong Han, Andrea Ruzzenente, Jennifer A. Yonkus, Victor Lopez-Lopez, Warsan Ismail, Richard D. Schulick, Matteo Mueller, Masayuki Ohtsuka, Wojciech G. Polak, Kim C Wagner, René Adam, Keun Soo Ahn, Rory L. Smoot, Joon Seong Park, Karim Boudjema, Takashi Mizuno, Ana Gleisner, Masato Nagino, Tsukasa Takayashiki, Gregory J. Gores, Tiffany C.L. Wong, Johann Pratschke, Chaya Shwaartz, Pierre-Alain Clavien, Mizelle D'Silva, Fabian Bartsch, Constantino Fondevila, Hauke Lang, Takehiro Noji, Ulf P. Neumann, Ricardo Robles-Campos, Ganesh Gunasekaran, Masakazu Yamamoto, Olivier Soubrane, Francesca Ratti, Andreas Prachalias, Katsuhiko Uesaka, Joris I. Erdmann, Myron Schwartz, Pål-Dag Line, Christian Benzing, Luca Aldrighetti, Amelia J. Hessheimer, Jan Bednarsch, Karl J. Oldhafer, Koo Jeong Kang, Michelle L. de Oliveira, Charles de Ponthaud, Chung Mau Lo, Gonzalo Sapisochin, Heithem Jeddou, Lynn E Nooijen, Hyung Sun Kim, Noémie Ammar-Khodja, Teiichi Sugiura, Bas Groot Koerkamp, Alfredo Guglielmi, Satoshi Hirano, Giuseppe Fusai |
---|---|
Přispěvatelé: | Mueller, M., Breuer, E., Mizuno, T., Bartsch, F., Ratti, F., Benzing, C., Ammar-Khodja, N., Sugiura, T., Takayashiki, T., Hessheimer, A., Kim, H. S., Ruzzenente, A., Ahn, K. S., Wong, T., Bednarsch, J., D'Silva, M., Koerkamp, B. G., Jeddou, H., Lopez-Lopez, V., de Ponthaud, C., Yonkus, J. A., Ismail, W., Nooijen, L. E., Hidalgo-Salinas, C., Kontis, E., Wagner, K. C., Gunasekaran, G., Higuchi, R., Gleisner, A., Shwaartz, C., Sapisochin, G., Schulick, R. D., Yamamoto, M., Noji, T., Hirano, S., Schwartz, M., Oldhafer, K. J., Prachalias, A., Fusai, G. K., Erdmann, J. I., Line, P. -D., Smoot, R. L., Soubrane, O., Robles-Campos, R., Boudjema, K., Polak, W. G., Han, H. -S., Neumann, U. P., Lo, C. -M., Kang, K. J., Guglielmi, A., Park, J. S., Fondevila, C., Ohtsuka, M., Uesaka, K., Adam, R., Pratschke, J., Aldrighetti, L., De Oliveira, M. L., Gores, G. J., Lang, H., Nagino, M., Clavien, P. -A., Surgery |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Percentile Asia Time Factors MEDLINE outcomes High morbidity Postoperative Complications SDG 3 - Good Health and Well-being Diabetes mellitus Internal medicine benchmarks 80 and over Medicine Hepatectomy Humans Perihilar Cholangiocarcinoma Aged Retrospective Studies Aged 80 and over business.industry CCI Mortality rate Middle Aged medicine.disease surgical complications major liver surgery United States Europe Benchmarking Editorial Bile Duct Neoplasms Benchmark (computing) Surgery Female business Body mass index perihilar cholangiocarcinoma Follow-Up Studies Klatskin Tumor |
Zdroj: | Hepatobiliary Surg Nutr Annals of Surgery, 274(5), 780-788. Lippincott Williams & Wilkins |
ISSN: | 1528-1140 0003-4932 |
Popis: | OBJECTIVE: The aim of this study was to define robust benchmark values for the surgical treatment of perihilar cholangiocarcinomas (PHC) to enable unbiased comparisons. BACKGROUND: Despite ongoing efforts, postoperative mortality and morbidity remains high after complex liver surgery for PHC. Benchmark data of best achievable results in surgical PHC treatment are however still lacking. METHODS: This study analyzed consecutive patients undergoing major liver surgery for PHC in 24 high-volume centers in 3 continents over the recent 5-year period (2014-2018) with a minimum follow-up of 1 year in each patient. Benchmark patients were those operated at high-volume centers (≥50 cases during the study period) without the need for vascular reconstruction due to tumor invasion, or the presence of significant co-morbidities such as severe obesity (body mass index ≥35), diabetes, or cardiovascular diseases. Benchmark cutoff values were derived from the 75th or 25th percentile of the median values of all benchmark centers. RESULTS: Seven hundred eight (39%) of a total of 1829 consecutive patients qualified as benchmark cases. Benchmark cut-offs included: R0 resection ≥57%, postoperative liver failure (International Study Group of Liver Surgery): ≤35%; in-hospital and 3-month mortality rates ≤8% and ≤13%, respectively; 3-month grade 3 complications and the CCI: ≤70% and ≤30.5, respectively; bile leak-rate: ≤47% and 5-year overall survival of ≥39.7%. Centers operating mostly on complex cases disclosed better outcome including lower post-operative liver failure rates (4% vs 13%; P = 0.002). Centers from Asia disclosed better outcomes. CONCLUSION: Surgery for PHC remains associated with high morbidity and mortality with now the availability of benchmark values covering 21 outcome parameters, which may serve as key references for comparison in any future analyses of individuals, group of patients or centers. |
Databáze: | OpenAIRE |
Externí odkaz: |