دورية أكاديمية
Multivariable prediction model for both 90-day mortality and long-term survival for individual patients with perihilar cholangiocarcinoma: does the predicted survival justify the surgical risk?
| العنوان: | Multivariable prediction model for both 90-day mortality and long-term survival for individual patients with perihilar cholangiocarcinoma: does the predicted survival justify the surgical risk? |
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| المؤلفون: | van Keulen, A. -M., Buettner, S., Erdmann, J. I., Pratschke, J., Ratti, F., Jarnagin, W. R., Schnitzbauer, A. A., Lang, H., Ruzzenente, A., Nadalin, S., Cescon, M., Topal, B., Olthof, P. B., Groot Koerkamp, B. |
| المساهمون: | van Keulen, A.-M., Buettner, S., Erdmann, J.I., Pratschke, J., Ratti, F., Jarnagin, W.R., Schnitzbauer, A.A., Lang, H., Ruzzenente, A., Nadalin, S., Cescon, M., Topal, B., Olthof, P.B., Groot Koerkamp, B. |
| سنة النشر: | 2023 |
| المجموعة: | IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: | perihilar cholangiocarcinoma |
| الوصف: | Background The risk of death after surgery for perihilar cholangiocarcinoma is high; nearly one in every five patients dies within 90 days after surgery. When the oncological benefit is limited, a high-risk resection may not be justified. This retrospective cohort study aimed to create two preoperative prognostic models to predict 90-day mortality and overall survival (OS) after major liver resection for perihilar cholangiocarcinoma. Methods Separate models were built with factors known before surgery using multivariable regression analysis for 90-day mortality and OS. Patients were categorized in three groups: favourable profile for surgical resection (90-day mortality rate below 10 per cent and predicted OS more than 3 years), unfavourable profile (90-day mortality rate above 25 per cent and/or predicted OS below 1.5 years), and an intermediate group. Results A total of 1673 patients were included. Independent risk factors for both 90-day mortality and OS included ASA grade III-IV, large tumour diameter, and right-sided hepatectomy. Additional risk factors for 90-day mortality were advanced age and preoperative cholangitis; those for long-term OS were high BMI, preoperative jaundice, Bismuth IV, and hepatic artery involvement. In total, 294 patients (17.6 per cent) had a favourable risk profile for surgery (90-day mortality rate 5.8 per cent and median OS 42 months), 271 patients (16.2 per cent) an unfavourable risk profile (90-day mortality rate 26.8 per cent and median OS 16 months), and 1108 patients (66.2 per cent) an intermediate risk profile (90-day mortality rate 12.5 per cent and median OS 27 months). Conclusion Preoperative risk models for 90-day mortality and OS can help identify patients with resectable perihilar cholangiocarcinoma who are unlikely to benefit from surgical resection. Tailored shared decision-making is particularly essential for the large intermediate group.When the oncological benefit is limited, a high-risk resection may be not be justified. Two preoperative prognostic models were ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/36918735; info:eu-repo/semantics/altIdentifier/wos/WOS:000948864200001; volume:110; issue:5; firstpage:599; lastpage:605; numberofpages:7; journal:BRITISH JOURNAL OF SURGERY; https://hdl.handle.net/11585/960359Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85152244850; https://academic.oup.com/bjs/article/110/5/599/7077832Test |
| DOI: | 10.1093/bjs/znad057 |
| الإتاحة: | https://doi.org/10.1093/bjs/znad057Test https://hdl.handle.net/11585/960359Test https://academic.oup.com/bjs/article/110/5/599/7077832Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.13A5FA7C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/bjs/znad057 |
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