A Multi-Institutional Analysis of Elderly Patients Undergoing a Liver Resection for Intrahepatic Cholangiocarcinoma

Detalhes bibliográficos
Autor(a) principal: Vitale, A
Data de Publicação: 2016
Outros Autores: 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
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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spelling 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
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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