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A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma

2016-03Journal article Open access
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dc.contributor.authorVitale, A
dc.contributor.authorSpolverato, G
dc.contributor.authorBagante, F
dc.contributor.authorGani, F
dc.contributor.authorPopescu, I
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorGamblin, TC
dc.contributor.authorMaithel, S
dc.contributor.authorSandroussi, C
dc.contributor.authorBauer, T
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, G
dc.contributor.authorMarsh, J
dc.contributor.authorPawlik, T
dc.date.accessioned2018-11-29T15:54:07Z
dc.date.available2018-11-29T15:54:07Z
dc.date.issued2016-03
dc.description.abstractBACKGROUND: Little is known regarding postoperative outcomes of elderly patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC). METHODS: Five hundred and eighty-four patients undergoing liver resection for ICC between 1990 and 2015 were identified. Perioperative morbidity, mortality, overall survival (OS), and disease-free survival (DFS) were compared between elderly (>70 year, n = 129) and non-elderly (≤70 years, n = 455) patients. RESULTS: Older patients had a higher incidence of complications (elderly vs. non-elderly; 52.7% vs. 42.6%; P = 0.03), as well as major complications (elderly vs. non-elderly; 24.0% vs. 14.9%; P = 0.01); 30-day (0.1% vs. 3.3%; P > 0.05), and 90-day mortality (2.3% vs. 5.5%; P > 0.05) were comparable. Five-year OS and DFS were comparable between the elderly and non-elderly patients (OS, 13.3% vs. 24.4%; and DFS; 7.3% vs. 12.0%; P > 0.05). On propensity score matching, DFS and OS were also comparable among non-elderly versus elderly patients. Poor tumor grade was associated with worse DFS among elderly patients (HR = 1.6, 95%CI 1.0-2.6; P = 0.04), whereas periductal invasion (HR = 1.9, 95% CI 1.1-3.5; P = 0.03) and nodal disease (HR = 2.3, 95% CI 1.3-3.9; P = 0.003) were predictive of shorter DFS among non-elderly patients. CONCLUSION: Elderly patients undergoing liver surgery for ICC demonstrated an increased risk of perioperative complications, but comparable long-term DFS and OS compared with younger patients. Rather, tumor characteristics were more predictive of worse long-term outcomes.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Surg Oncol. 2016 Mar;113(4):420-6.pt_PT
dc.identifier.doi10.1002/jso.24148pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3113
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectBile Duct Neoplasmspt_PT
dc.subjectCholangiocarcinomapt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectDisease-Free Survivalpt_PT
dc.subjectFemalept_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectKaplan-Meier Estimatept_PT
dc.subjectLogistic Modelspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectHCC CIRpt_PT
dc.titleA Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage426pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage420pt_PT
oaire.citation.titleJournal of Surgical Oncologypt_PT
oaire.citation.volume113pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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