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Hospital Variation in Textbook Outcomes Following Curative-Intent Resection of Hepatocellular Carcinoma: an International Multi-Institutional Analysis

2020-09Journal article Open access
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dc.contributor.authorTsilimigras, D
dc.contributor.authorMehta, R
dc.contributor.authorMerath, K
dc.contributor.authorBagante, F
dc.contributor.authorParedes, AZ
dc.contributor.authorFarooq, A
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSilva, S
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorGrigorie, R
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorWorkneh, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorHugh, T
dc.contributor.authorAldrighetti, L
dc.contributor.authorEndo, I
dc.contributor.authorPawlik, T
dc.date.accessioned2021-03-17T15:14:57Z
dc.date.available2021-03-17T15:14:57Z
dc.date.issued2020-09
dc.description.abstractBackground: Composite measures such as "Textbook Outcome" (TO) may be superior to individual quality metrics to assess surgical care and hospital performance. However, the incidence and factors associated with TO after resection of HCC remain poorly defined. Methods: Hospital variation in the rates of TO, factors associated with achieving a TO and the impact of TO on long-term survival following resection for HCC were examined using an international multi-institutional database. Results: Among 605 patients who underwent curative-intent resection of HCC, the unadjusted incidence of TO ranged from 50.9% to 77.7%. While achievement of each individual quality metric was relatively high (range, 74.5-98.0%), an overall TO was achieved among only 62.3% (n = 377) of patients. At the hospital level, TO ranged from 54.3% to 72.9%. Patients with BCLC-0 HCC (referent BCLC-B/C; OR: 4.17, 95%CI: 1.62-10.7) and ALBI grade 1 (referent ALBI grade 2/3; OR: 1.49, 95%CI: 1.06-2.11) had higher odds of achieving a TO. On multivariable analysis, TO was associated with improved overall survival (HR: 0.60, 95% CI: 0.42-0.85). Conclusion: Roughly 6 in 10 patients achieved a TO following resection for HCC. When achieved, TO was associated with better long-term outcomes. TO is a simple composite measure of both short- and long-term outcomes among patients undergoing resection for HCC.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHPB (Oxford). 2020 Sep;22(9):1305-1313.pt_PT
dc.identifier.doi10.1016/j.hpb.2019.12.005pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3597
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectHospitals
dc.subjectCarcinoma, Hepatocellular* / surgery
dc.subjectHepatectomy / adverse effects
dc.subjectLiver Neoplasms* / surgery
dc.subjectRetrospective Studies
dc.titleHospital Variation in Textbook Outcomes Following Curative-Intent Resection of Hepatocellular Carcinoma: an International Multi-Institutional Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1313pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage1305pt_PT
oaire.citation.titleHPB: the official journal of the International Hepato Pancreato Biliary Associationpt_PT
oaire.citation.volume22pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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