A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3113 |
Resumo: | BACKGROUND: Little is known regarding postoperative outcomes of elderly patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC). METHODS: Five hundred and eighty-four patients undergoing liver resection for ICC between 1990 and 2015 were identified. Perioperative morbidity, mortality, overall survival (OS), and disease-free survival (DFS) were compared between elderly (>70 year, n = 129) and non-elderly (≤70 years, n = 455) patients. RESULTS: Older patients had a higher incidence of complications (elderly vs. non-elderly; 52.7% vs. 42.6%; P = 0.03), as well as major complications (elderly vs. non-elderly; 24.0% vs. 14.9%; P = 0.01); 30-day (0.1% vs. 3.3%; P > 0.05), and 90-day mortality (2.3% vs. 5.5%; P > 0.05) were comparable. Five-year OS and DFS were comparable between the elderly and non-elderly patients (OS, 13.3% vs. 24.4%; and DFS; 7.3% vs. 12.0%; P > 0.05). On propensity score matching, DFS and OS were also comparable among non-elderly versus elderly patients. Poor tumor grade was associated with worse DFS among elderly patients (HR = 1.6, 95%CI 1.0-2.6; P = 0.04), whereas periductal invasion (HR = 1.9, 95% CI 1.1-3.5; P = 0.03) and nodal disease (HR = 2.3, 95% CI 1.3-3.9; P = 0.003) were predictive of shorter DFS among non-elderly patients. CONCLUSION: Elderly patients undergoing liver surgery for ICC demonstrated an increased risk of perioperative complications, but comparable long-term DFS and OS compared with younger patients. Rather, tumor characteristics were more predictive of worse long-term outcomes. |
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A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic CholangiocarcinomaAge FactorsAgedBile Duct NeoplasmsCholangiocarcinomaDatabases, FactualDisease-Free SurvivalFemaleHepatectomyHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedHCC CIRBACKGROUND: Little is known regarding postoperative outcomes of elderly patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC). METHODS: Five hundred and eighty-four patients undergoing liver resection for ICC between 1990 and 2015 were identified. Perioperative morbidity, mortality, overall survival (OS), and disease-free survival (DFS) were compared between elderly (>70 year, n = 129) and non-elderly (≤70 years, n = 455) patients. RESULTS: Older patients had a higher incidence of complications (elderly vs. non-elderly; 52.7% vs. 42.6%; P = 0.03), as well as major complications (elderly vs. non-elderly; 24.0% vs. 14.9%; P = 0.01); 30-day (0.1% vs. 3.3%; P > 0.05), and 90-day mortality (2.3% vs. 5.5%; P > 0.05) were comparable. Five-year OS and DFS were comparable between the elderly and non-elderly patients (OS, 13.3% vs. 24.4%; and DFS; 7.3% vs. 12.0%; P > 0.05). On propensity score matching, DFS and OS were also comparable among non-elderly versus elderly patients. Poor tumor grade was associated with worse DFS among elderly patients (HR = 1.6, 95%CI 1.0-2.6; P = 0.04), whereas periductal invasion (HR = 1.9, 95% CI 1.1-3.5; P = 0.03) and nodal disease (HR = 2.3, 95% CI 1.3-3.9; P = 0.003) were predictive of shorter DFS among non-elderly patients. CONCLUSION: Elderly patients undergoing liver surgery for ICC demonstrated an increased risk of perioperative complications, but comparable long-term DFS and OS compared with younger patients. Rather, tumor characteristics were more predictive of worse long-term outcomes.WileyRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEVitale, ASpolverato, GBagante, FGani, FPopescu, IPinto Marques, HAldrighetti, LGamblin, TCMaithel, SSandroussi, CBauer, TShen, FPoultsides, GMarsh, JPawlik, T2018-11-29T15:54:07Z2016-032016-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3113engJ Surg Oncol. 2016 Mar;113(4):420-6.10.1002/jso.24148info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:41:18Zoai:repositorio.chlc.min-saude.pt:10400.17/3113Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:27.023930Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
title |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
spellingShingle |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma Vitale, A Age Factors Aged Bile Duct Neoplasms Cholangiocarcinoma Databases, Factual Disease-Free Survival Female Hepatectomy Humans Kaplan-Meier Estimate Logistic Models Male Middle Aged HCC CIR |
title_short |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
title_full |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
title_fullStr |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
title_full_unstemmed |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
title_sort |
A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma |
author |
Vitale, A |
author_facet |
Vitale, A Spolverato, G Bagante, F Gani, F Popescu, I Pinto Marques, H Aldrighetti, L Gamblin, TC Maithel, S Sandroussi, C Bauer, T Shen, F Poultsides, G Marsh, J Pawlik, T |
author_role |
author |
author2 |
Spolverato, G Bagante, F Gani, F Popescu, I Pinto Marques, H Aldrighetti, L Gamblin, TC Maithel, S Sandroussi, C Bauer, T Shen, F Poultsides, G Marsh, J Pawlik, T |
author2_role |
author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Vitale, A Spolverato, G Bagante, F Gani, F Popescu, I Pinto Marques, H Aldrighetti, L Gamblin, TC Maithel, S Sandroussi, C Bauer, T Shen, F Poultsides, G Marsh, J Pawlik, T |
dc.subject.por.fl_str_mv |
Age Factors Aged Bile Duct Neoplasms Cholangiocarcinoma Databases, Factual Disease-Free Survival Female Hepatectomy Humans Kaplan-Meier Estimate Logistic Models Male Middle Aged HCC CIR |
topic |
Age Factors Aged Bile Duct Neoplasms Cholangiocarcinoma Databases, Factual Disease-Free Survival Female Hepatectomy Humans Kaplan-Meier Estimate Logistic Models Male Middle Aged HCC CIR |
description |
BACKGROUND: Little is known regarding postoperative outcomes of elderly patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC). METHODS: Five hundred and eighty-four patients undergoing liver resection for ICC between 1990 and 2015 were identified. Perioperative morbidity, mortality, overall survival (OS), and disease-free survival (DFS) were compared between elderly (>70 year, n = 129) and non-elderly (≤70 years, n = 455) patients. RESULTS: Older patients had a higher incidence of complications (elderly vs. non-elderly; 52.7% vs. 42.6%; P = 0.03), as well as major complications (elderly vs. non-elderly; 24.0% vs. 14.9%; P = 0.01); 30-day (0.1% vs. 3.3%; P > 0.05), and 90-day mortality (2.3% vs. 5.5%; P > 0.05) were comparable. Five-year OS and DFS were comparable between the elderly and non-elderly patients (OS, 13.3% vs. 24.4%; and DFS; 7.3% vs. 12.0%; P > 0.05). On propensity score matching, DFS and OS were also comparable among non-elderly versus elderly patients. Poor tumor grade was associated with worse DFS among elderly patients (HR = 1.6, 95%CI 1.0-2.6; P = 0.04), whereas periductal invasion (HR = 1.9, 95% CI 1.1-3.5; P = 0.03) and nodal disease (HR = 2.3, 95% CI 1.3-3.9; P = 0.003) were predictive of shorter DFS among non-elderly patients. CONCLUSION: Elderly patients undergoing liver surgery for ICC demonstrated an increased risk of perioperative complications, but comparable long-term DFS and OS compared with younger patients. Rather, tumor characteristics were more predictive of worse long-term outcomes. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-03 2016-03-01T00:00:00Z 2018-11-29T15:54:07Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3113 |
url |
http://hdl.handle.net/10400.17/3113 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
J Surg Oncol. 2016 Mar;113(4):420-6. 10.1002/jso.24148 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Wiley |
publisher.none.fl_str_mv |
Wiley |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131300654743552 |