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Postoperative Infectious Complications Worsen Long-Term Survival After Curative-Intent Resection for Hepatocellular Carcinoma

2021Journal article Open access
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dc.contributor.authorWei, T
dc.contributor.authorZhang, XF
dc.contributor.authorBagante, F
dc.contributor.authorRatti, F
dc.contributor.authorMarques, HP
dc.contributor.authorSilva, S
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, GA
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, TM
dc.date.accessioned2022-11-07T15:30:02Z
dc.date.available2022-11-07T15:30:02Z
dc.date.issued2021
dc.description.abstractBackground: Postoperative infectious complications may be associated with a worse long-term prognosis for patients undergoing surgery for a malignant indication. The current study aimed to characterize the impact of postoperative infectious complications on long-term oncologic outcomes among patients undergoing resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. The relationship between postoperative infectious complications, overall survival (OS), and recurrence-free survival (RFS) was analyzed. Results: Among 734 patients who underwent HCC resection, 269 (36.6%) experienced a postoperative complication (Clavien-Dindo grade 1 or 2 [n = 197, 73.2%] vs grade 3 and 4 [n = 69, 25.7%]). An infectious complication was noted in 81 patients (11.0%) and 188 patients (25.6%) had non-infectious complications. The patients with infectious complications had worse OS (median: infectious complications [46.5 months] vs no complications [106.4 months] [p < 0.001] and non-infectious complications [85.7 months] [p < 0.05]) and RFS (median: infectious complications [22.1 months] vs no complications [45.5 months] [p < 0.05] and non-infectious complications [38.3 months] [p = 0.139]) than the patients who had no complication or non-infectious complications. In the multivariable analysis, infectious complications remained an independent risk factor for OS (hazard ratio [HR], 1.7; p = 0.016) and RFS (HR, 1.6; p = 0.013). Among the patients with infectious complications, patients with non-surgical-site infection (SSI) had even worse OS and RFS than patients with SSI (median OS: 19.5 vs 70.9 months [p = 0.010]; median RFS: 12.8 vs 33.9 months [p = 0.033]). Conclusion: Infectious complications were independently associated with an increased long-term risk of tumor recurrence and death. Patients with non-SSI versus SSI had a particularly worse oncologic outcome.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol. 2022 Jan;29(1):315-324.pt_PT
dc.identifier.doi10.1245/s10434-021-10565-2pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4266
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerlinkpt_PT
dc.subjectHepatocellular, complicationspt_PT
dc.subjectInfectionpt_PT
dc.subjectResectionpt_PT
dc.subjectOutcomespt_PT
dc.subjectHCC CHBPTpt_PT
dc.titlePostoperative Infectious Complications Worsen Long-Term Survival After Curative-Intent Resection for Hepatocellular Carcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage324pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage315pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume29pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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