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Article: Major postoperative complications compromise oncological outcomes of patients with intrahepatic cholangiocarcinoma after curative resection - A 13-year cohort in a tertiary center

TitleMajor postoperative complications compromise oncological outcomes of patients with intrahepatic cholangiocarcinoma after curative resection - A 13-year cohort in a tertiary center
Authors
KeywordsIntrahepatic cholangiocarcinoma
Hepatectomy
Post-operative complication
Oncological outcomes
Issue Date2019
PublisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at https://www.journals.elsevier.com/asian-journal-of-surgery/
Citation
Asian Journal of Surgery, 2019, v. 42 n. 1, p. 164-171 How to Cite?
AbstractBackground/Objective: Hepatectomy is the mainstay of curative treatment for intrahepatic cholangiocarcinoma (ICC). The relationship between postoperative complication and oncological outcome has not been defined. We aimed to elucidate the effect of postoperative complication on long-term survival of ICC patients after curative resection. Methods: Data of consecutive patients who had curative resection for ICC at our hospital from 1991 to 2013 were reviewed. Patients with cholangiohepatocellular carcinoma, metastatic adenocarcinoma or Klaskin tumor were excluded. Clinicopathological data and postoperative events were extracted from database for survival analysis. Results: There were 107 patients in our series. Their median age was 61 years. The median follow-up time was 24 months. The median tumor size was 6 cm. Major hepatectomy was required in 52.3% of them. The median operation time and blood loss was 439 minutes and 0.9L respectively. R0 resection was achieved in 88.8% of them. The median length of stay was 11 days. The 30-day and 90-day mortality was 2.5% and 6.8% respectively. Major complications were found in 20.6% of them. Patients with postoperative complications had significantly inferior survival than patients without (3-yr DFS 38% vs. 27%, P = 0.001; 3-yr overall: 51% vs. 27%, P < 0.001). Multivariable analysis showed that postoperative complication was an independent factor associated with disease-free survival (OR 1.9 95% C.I. 1.10–3.24, P = 0.021) and overall survival (OR 2.1, 95% C.I. 1.13–3.93, P = 0.018). Conclusion: Postoperative complication has a significant impact on ICC patients' long-term survival. Extra measures such as adjuvant chemotherapy should be considered for patients who develop major complications after surgery.
Persistent Identifierhttp://hdl.handle.net/10722/259533
ISSN
2019 Impact Factor: 1.838
2015 SCImago Journal Rankings: 0.427
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMa, KW-
dc.contributor.authorCheung, TT-
dc.contributor.authorShe, WH-
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, ACY-
dc.contributor.authorDai, WC-
dc.contributor.authorTsang, HYS-
dc.contributor.authorLo, CM-
dc.date.accessioned2018-09-03T04:09:29Z-
dc.date.available2018-09-03T04:09:29Z-
dc.date.issued2019-
dc.identifier.citationAsian Journal of Surgery, 2019, v. 42 n. 1, p. 164-171-
dc.identifier.issn1015-9584-
dc.identifier.urihttp://hdl.handle.net/10722/259533-
dc.description.abstractBackground/Objective: Hepatectomy is the mainstay of curative treatment for intrahepatic cholangiocarcinoma (ICC). The relationship between postoperative complication and oncological outcome has not been defined. We aimed to elucidate the effect of postoperative complication on long-term survival of ICC patients after curative resection. Methods: Data of consecutive patients who had curative resection for ICC at our hospital from 1991 to 2013 were reviewed. Patients with cholangiohepatocellular carcinoma, metastatic adenocarcinoma or Klaskin tumor were excluded. Clinicopathological data and postoperative events were extracted from database for survival analysis. Results: There were 107 patients in our series. Their median age was 61 years. The median follow-up time was 24 months. The median tumor size was 6 cm. Major hepatectomy was required in 52.3% of them. The median operation time and blood loss was 439 minutes and 0.9L respectively. R0 resection was achieved in 88.8% of them. The median length of stay was 11 days. The 30-day and 90-day mortality was 2.5% and 6.8% respectively. Major complications were found in 20.6% of them. Patients with postoperative complications had significantly inferior survival than patients without (3-yr DFS 38% vs. 27%, P = 0.001; 3-yr overall: 51% vs. 27%, P < 0.001). Multivariable analysis showed that postoperative complication was an independent factor associated with disease-free survival (OR 1.9 95% C.I. 1.10–3.24, P = 0.021) and overall survival (OR 2.1, 95% C.I. 1.13–3.93, P = 0.018). Conclusion: Postoperative complication has a significant impact on ICC patients' long-term survival. Extra measures such as adjuvant chemotherapy should be considered for patients who develop major complications after surgery.-
dc.languageeng-
dc.publisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at https://www.journals.elsevier.com/asian-journal-of-surgery/-
dc.relation.ispartofAsian Journal of Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectIntrahepatic cholangiocarcinoma-
dc.subjectHepatectomy-
dc.subjectPost-operative complication-
dc.subjectOncological outcomes-
dc.titleMajor postoperative complications compromise oncological outcomes of patients with intrahepatic cholangiocarcinoma after curative resection - A 13-year cohort in a tertiary center-
dc.typeArticle-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailShe, WH: brianshe@hku.hk-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailDai, WC: daiwc@HKUCC-COM.hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityChok, KSH=rp02110-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityLo, CM=rp00412-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.asjsur.2018.01.004-
dc.identifier.pmid29472064-
dc.identifier.scopuseid_2-s2.0-85042141500-
dc.identifier.hkuros288592-
dc.identifier.volume42-
dc.identifier.issue1-
dc.identifier.spage164-
dc.identifier.epage171-
dc.identifier.isiWOS:000454143100022-
dc.publisher.placeHong Kong-

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