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An Attempt to Establish and Apply Global Benchmarks for Liver Resection of Malignant Hepatic Tumors

2023-12Journal article Open access
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dc.contributor.authorAlaimo, L
dc.contributor.authorMoazzam, Z
dc.contributor.authorLima, H
dc.contributor.authorEndo, Y
dc.contributor.authorRuzzenente, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorRatti, F
dc.contributor.authorAldrighetti, L
dc.contributor.authorWeiss, M
dc.contributor.authorBauer, T
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPopescu, I
dc.contributor.authorPoultsides, G
dc.contributor.authorMaithel, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorMartel, G
dc.contributor.authorPulitano, C
dc.contributor.authorShen, F
dc.contributor.authorCauchy, F
dc.contributor.authorKoerkamp, B
dc.contributor.authorEndo, I
dc.contributor.authorKitago, M
dc.contributor.authorAucejo, F
dc.contributor.authorSasaki, K
dc.contributor.authorFields, R.
dc.contributor.authorHugh, T
dc.contributor.authorLam, V
dc.contributor.authorPawlik, T
dc.date.accessioned2023-12-22T15:49:09Z
dc.date.available2023-12-22T15:49:09Z
dc.date.issued2023-12
dc.description.abstractBackground: Benchmarking is a process of continuous self-evaluation and comparison with best-in-class hospitals to guide quality improvement initiatives. We sought to define global benchmarks relative to liver resection for malignancy and to assess their achievement in hospitals in the United States. Methods: Patients who underwent curative-intent liver resection for hepatocellular carcinoma, intrahepatic cholangiocarcinoma, or colorectal or neuroendocrine liver metastases between 2000 and 2019 were identified from an international multi-institutional database. Propensity score matching was conducted to balance baseline characteristics between open and minimally invasive approaches. Best-in-class hospitals were defined relative to the achievement rate of textbook oncologic outcomes and case volume. Benchmark values were established relative to best-in-class institutions. The achievement of benchmark values among hospitals in the National Cancer Database was then assessed. Results: Among 2,624 patients treated at 20 centers, a majority underwent liver resection for hepatocellular carcinoma (n = 1,609, 61.3%), followed by colorectal liver metastases (n = 650, 24.8%), intrahepatic cholangiocarcinoma (n = 299, 11.4%), and neuroendocrine liver metastases (n = 66, 2.5%). Notably, 1,947 (74.2%) patients achieved a textbook oncologic outcome. After propensity score matching, 6 best-in-class hospitals with the highest textbook oncologic outcome rates (≥75.0%) were identified. Benchmark values were calculated for margin positivity (≤11.7%), 30-day readmission (≤4.1%), 30-day mortality (≤1.6%), minor postoperative complications (≤24.7%), severe complications (≤12.4%), and failure to achieve the textbook oncologic outcome (≤22.8%). Among the National Cancer Database hospitals, global benchmarks for margin positivity, 30-day readmission, 30-day mortality, severe complications, and textbook oncologic outcome failure were achieved in 62.9%, 27.1%, 12.1%, 7.1%, and 29.3% of centers, respectively. Conclusion: These global benchmarks may help identify hospitals that may benefit from quality improvement initiatives, aiming to improve patient safety and surgical oncologic outcomes.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSurgery . 2023 Dec;174(6):1384-1392.pt_PT
dc.identifier.doi10.1016/j.surg.2023.08.024pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4768
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectBenchmarkingpt_PT
dc.subjectBile Duct Neoplasms*pt_PT
dc.subjectBile Ducts, Intrahepaticpt_PT
dc.subjectCarcinoma, Hepatocellular* / surgerypt_PT
dc.subjectCholangiocarcinoma*pt_PT
dc.subjectColorectal Neoplasms*pt_PT
dc.subjectLiver Neoplasms* / surgerypt_PT
dc.titleAn Attempt to Establish and Apply Global Benchmarks for Liver Resection of Malignant Hepatic Tumorspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1392pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1384pt_PT
oaire.citation.titleSurgerypt_PT
oaire.citation.volume174pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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