Repository logo
 
Publication

Perioperative and Long-Term Outcome for Intrahepatic Cholangiocarcinoma: Impact of Major Versus Minor Hepatectomy

2017-11Journal article Open access
Simple item page
dc.contributor.authorZhang, XF
dc.contributor.authorBagante, F
dc.contributor.authorChakedis, J
dc.contributor.authorMoris, D
dc.contributor.authorBeal, EW
dc.contributor.authorWeiss, M
dc.contributor.authorPopescu, I
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorGroot Koerkamp, B
dc.contributor.authorGuglielmi, A
dc.contributor.authorItaru, E
dc.contributor.authorPawlik, TM
dc.date.accessioned2018-03-02T15:49:19Z
dc.date.available2018-03-02T15:49:19Z
dc.date.issued2017-11
dc.description.abstractBACKGROUND: The objective of the current study was to investigate both short- and long-term outcomes of patients undergoing curative-intent resection for intrahepatic cholangiocarcinoma (ICC) stratified by extent of hepatic resection relative to overall final pathological margin status. METHODS: One thousand twenty-three patients with ICC who underwent curative-intent resection were identified from a multi-institutional database. Demographic, clinicopathological, and operative data, as well as overall (OS) and recurrence-free survival (RFS) were compared among patients undergoing major and minor resection before and after propensity score matching. RESULTS: Overall, 608 (59.4%) patients underwent major hepatectomy, while 415 (40.6%) had a minor resection. Major hepatectomy was more frequently performed among patients who had large, multiple, and bilobar tumors. Roughly half of patients (n = 294, 48.4%) developed a postoperative complication following major hepatectomy versus only one fourth of patients (n = 113, 27.2%) after minor resection (p < 0.001). In the propensity model, patients who underwent major hepatectomy had an equivalent OS and RFS versus patients who had a minor hepatectomy (median OS, 38 vs. 37 months, p = 0.556; and median RFS, 20 vs. 18 months, p = 0.635). Patients undergoing major resection had comparable OS and RFS with wide surgical margin (≥10 and 5-9 mm), but improved RFS when surgical margin was narrow (1-4 mm) versus minor resection in the propensity model. In the Cox regression model, tumor characteristics and surgical margin were independently associated with long-term outcome. CONCLUSIONS: Major hepatectomy for ICC was not associated with an overall survival benefit, yet was associated with increased perioperative morbidity. Margin width, rather than the extent of resection, affected long-term outcomes. Radical parenchymal-sparing resection should be advocated if a margin clearance of ≥5 mm can be achieved.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Gastrointest Surg. 2017 Nov;21(11):1841-1850.pt_PT
dc.identifier.doi10.1007/s11605-017-3499-6pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2926
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Verlagpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectBile Duct Neoplasms/mortalitypt_PT
dc.subjectBile Duct Neoplasms/pathologypt_PT
dc.subjectBile Duct Neoplasms/surgerypt_PT
dc.subjectBile Ducts, Intrahepatic/surgerypt_PT
dc.subjectCholangiocarcinoma/mortalitypt_PT
dc.subjectCholangiocarcinoma/pathology
dc.subjectCholangiocarcinoma/surgery
dc.subjectCohort Studies
dc.subjectHepatectomy
dc.subjectSurvival Analysis
dc.subjectTreatment Outcome
dc.titlePerioperative and Long-Term Outcome for Intrahepatic Cholangiocarcinoma: Impact of Major Versus Minor Hepatectomypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1850pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage1841pt_PT
oaire.citation.titleJournal of Gastrointestinal Surgerypt_PT
oaire.citation.volume21pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
J Gastrointest Surg 2017 1841.pdf
Size:
865.89 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

CIR - Artigos