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01-09-2020 | Liver Surgery | Hepatobiliary Tumors

Assessing Textbook Outcomes Following Liver Surgery for Primary Liver Cancer Over a 12-Year Time Period at Major Hepatobiliary Centers

Authors: Diamantis I. Tsilimigras, MD, Kota Sahara, MD, Dimitrios Moris, MD, PhD, Rittal Mehta, MPH, BDS, Anghela Z. Paredes, MD, MS, Francesca Ratti, MD, Hugo P. Marques, MD, Olivier Soubrane, MD, Vincent Lam, MD, George A. Poultsides, MD, Irinel Popescu, MD, Sorin Alexandrescu, MD, Guillaume Martel, MD, Aklile Workneh, MD, Alfredo Guglielmi, MD, Tom Hugh, MD, Luca Aldrighetti, MD, Matthew Weiss, MD, Todd W. Bauer, MD, Shishir K. Maithel, MD, Carlo Pulitano, MD, Feng Shen, MD, Bas Groot Koerkamp, MD, Itaru Endo, MD, PhD, Timothy M. Pawlik, MD, MPH, PhD

Published in: Annals of Surgical Oncology | Issue 9/2020

Abstract

Introduction

The objective of the current study was to comprehensively assess the change of practice in hepatobiliary surgery by determining the rates and the trends of textbook outcomes (TO) among patients undergoing surgery for primary liver cancer over time.

Methods

Patients undergoing curative-intent resection for primary liver malignancies, including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) between 2005 and 2017 were analyzed using a large, international multi-institutional dataset. Rates of TO were assessed over time. Factors associated with achieving a TO and the impact of TO on long-term survival were examined.

Results

Among 1829 patients, 944 (51.6%) and 885 (48.4%) individuals underwent curative-intent resection for HCC and ICC, respectively. Over time, patients were older, more frequently had ASA class > 2, albumin-bilirubin grade 2/3, major vascular invasion and more frequently underwent major liver resection (all p < 0.05). Overall, a total of 1126 (62.0%) patients achieved a TO. No increasing trends in TO rates were noted over the years (p_trend = 0.90). In addition, there was no increasing trend in the TO rates among patients undergoing either major (p_trend = 0.39) or minor liver resection (p_trend = 0.63) over the study period. Achieving a TO was independently associated with 26% and 37% decreased hazards of death among ICC (HR 0.74, 95%CI 0.56–0.97) and HCC patients (HR 0.63, 95%CI 0.46–0.85), respectively.

Conclusion

Approximately 6 in 10 patients undergoing surgery for primary liver tumors achieved a TO. While TO rates did not increase over time, TO was associated with better long-term outcomes following liver resection for both HCC and ICC.

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Title: Assessing Textbook Outcomes Following Liver Surgery for Primary Liver Cancer Over a 12-Year Time Period at Major Hepatobiliary Centers
Authors: Diamantis I. Tsilimigras, MD
Kota Sahara, MD
Dimitrios Moris, MD, PhD
Rittal Mehta, MPH, BDS
Anghela Z. Paredes, MD, MS
Francesca Ratti, MD
Hugo P. Marques, MD
Olivier Soubrane, MD
Vincent Lam, MD
George A. Poultsides, MD
Irinel Popescu, MD
Sorin Alexandrescu, MD
Guillaume Martel, MD
Aklile Workneh, MD
Alfredo Guglielmi, MD
Tom Hugh, MD
Luca Aldrighetti, MD
Matthew Weiss, MD
Todd W. Bauer, MD
Shishir K. Maithel, MD
Carlo Pulitano, MD
Feng Shen, MD
Bas Groot Koerkamp, MD
Itaru Endo, MD, PhD
Timothy M. Pawlik, MD, MPH, PhD
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Liver Surgery
Liver Resection
Liver Surgery
Liver Resection
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Annals of Surgical Oncology / Issue 9/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08548-w

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Assessing Textbook Outcomes Following Liver Surgery for Primary Liver Cancer Over a 12-Year Time Period at Major Hepatobiliary Centers

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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