Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma. Issue 16 (22nd April 2015)

• Record Type: Journal Article
• Authors: Spolverato, Gaya; Yakoob, Mohammad Y.; Kim, Yuhree; Alexandrescu, Sorin; Marques, Hugo P.; Lamelas, Jorge; Aldrighetti, Luca; Gamblin, T. Clark; Maithel, Shishir K.; Pulitano, Carlo; Bauer, Todd W.; Shen, Feng; Poultsides, George A.; Marsh, J. Wallis; Pawlik, Timothy M.
• Is Part Of: Cancer. Volume 121:Issue 16(2015)
• Page Start: 2730
• Page End: 2739
• Publication Date: 2015-04-22
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29419
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29419-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The impact of postoperative complications on the long‐term outcomes of patients undergoing surgery for cancer is unclear. The objective of the current study was to define the incidence of complications among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC) and identify the association between morbidity and long‐term outcomes.</p> </sec> <sec id="cncr29419-sec-0002" sec-type="section"> <title>METHODS</title> <p>A total of 583 patients undergoing surgery with curative intent for ICC between 1990 and 2013 at 1 of 12 participating institutions were identified. The association between the occurrence and severity of postoperative complications on long‐term survival was analyzed.</p> </sec> <sec id="cncr29419-sec-0003" sec-type="section"> <title>RESULTS</title> <p>The median age of the patients was 59.9 years and the majority of patients were male (52.3%). A total of 91 patients (15.6%) and 153 patients (26.2%) developed a major and minor postoperative complication, respectively; 18 patients (3.5%) died within 90 days of surgery. Median, 1‐year, 3‐year, and 5‐year recurrence‐free survival were 10.0 months, 43.3%, 16.7%, and 11.1%, respectively. Postoperative complications (hazard ratio [HR], 1.37, 95% confidence interval [95% CI], 1.08‐1.73 [<italic>P</italic> = .01]) and severity of complications (major vs none: HR, 1.55; 95% CI, 1.14‐2.11 [<italic>P</italic> = .01]; minor vs none: HR, 1.30; 95% CI, 0.99‐1.70 [<italic>P</italic> = .06]) independently predicted shorter recurrence‐free survival. Median, 1‐year, 3‐year, and 5‐year overall survival was 27.8 months, 76.8%, 39.0%, and 23.4%, respectively. Postoperative complications (HR, 1.64; 95% CI, 1.30‐2.08 [<italic>P</italic><.001]) and severity of complications (major vs none: HR, 1.79; 95% CI, 1.31‐2.44 [<italic>P</italic><.001]; minor vs none: HR, 1.50; 95% CI, 1.15‐1.95 [<italic>P</italic><.01]) independently predicted shorter overall survival.</p> </sec> <sec id="cncr29419-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Postoperative complications were found to be independent predictors of worse long‐term outcomes. The prevention and management of postoperative complications is crucial to increase both short‐term and long‐term survival. <bold><italic>Cancer</italic> 2015;121:2730‐2739.</bold> © <italic>2015 American Cancer Society</italic></p> </sec> </abstract>