Failure to Rescue After Resection of Perhilar Cholangiocarcinoma in an International Multicenter Cohort
Articolo
Data di Pubblicazione:
2025
Citazione:
Failure to Rescue After Resection of Perhilar Cholangiocarcinoma in an International Multicenter Cohort / Olthof, P. B.; Bouwense, S. A. W.; Bednarsch, J.; Dewulf, M.; Kazemier, G.; Maithel, S.; Jarnagin, W. R.; Aldrighetti, L.; Roberts, K. J.; Troisi, R. I.; Malago, M. M.; Lang, H.; Alikhanov, R.; Ruzzenente, A.; Malik, H.; Charco, R.; Sparrelid, E.; Pratschke, J.; Cescon, M.; Nadalin, S.; Hagendoorn, J.; Schadde, E.; Hoogwater, F. J. H.; Schnitzbauer, A. A.; Topal, B.; Lodge, P.; Olde Damink, S. W. M.; Neumann, U. P.; Groot Koerkamp, B.; Zonderhuis, B. M.; Van Laarhoven, S.; Topal, H.; Sutcliff, R.; Sultana, A.; Serenari, M.; Schmelzle, M.; Rolinger, J.; Ravaioli, M.; Ratti, F.; Quinn, L. M.; Prasad, R.; Porte, R. J.; Poletto, E.; Nota, C. L. M.; Nooijen, L. E.; Nguyen, T. A.; Molenaar, Q. I.; Marino, R.; Margies, R.; Maithel, S. K.; Kingham, T. P.; Jansson, H.; Heil, J.; Hakeem, A.; Van Gulik, T. M.; Guglielmi, A.; Gomez-Gavara, C.; Gilg, S.; Giglio, M. C.; Geers, J.; Franken, L. C.; Erdmann, J. I.; Efanov, M.; Dopazo, C.; De Savornin Lohman, E.; De Reuver, P.; D'Angelica, M. I.; Capobianco, I.; Buettner, S.; De Boer, M. T.; Benzing, C.; Bednarsch, J.; Bechstein, W. O.; Bartlett Dm Bartsch, F.. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - 32:3(2025), pp. 1762-1768. [10.1245/s10434-024-16293-7]
Abstract:
Background: Failure to rescue (FTR) is defined as the inability to prevent death after the development of a complication. FTR is a parameter in evaluating multidisciplinary postoperative complication management. The aim of this study was to evaluate FTR rates after major liver resection for perihilar cholangiocarcinoma (pCCA) and analyze factors associated with FTR. Patients and Method: Patients who underwent major liver resection for pCCA at 27 centers were included. FTR was defined as the presence of a Dindo grade III or higher complication followed by death within 90 days after surgery. Liver failure ISGLS grade B/C were scored. Multivariable logistic analysis was performed to identify predictors of FTR and reported using odds ratio and 95% confidence intervals. Results: In the 2186 included patients, major morbidity rate was 49%, 90-day mortality rate 13%, and FTR occurred in 24% of patients with a grade III or higher complication. Across centers, major complication rate varied from 19 to 87%, 90-day mortality rate from 5 to 33%, and FTR ranged from 11 to 50% across hospitals. Age [1.04 (1.02–1.05) years], ASA 3 or 4 [1.40 (1.01–1.95)], jaundice at presentation [1.79 (1.16–2.76)], right-sided resection [1.45 (1.06–1.98)], and annual hospital volume < 6 [1.44 (1.07–1.94)] were positively associated with FTR. When liver failure is included, the odds ratio for FTR is 9.58 (6.76–13.68). Conclusion: FTR occurred in 24% of patients after resection for pCCA. Liver failure was associated with a nine-fold increase of FTR and hospital volume below six was also associated with an increased risk of FTR.
Tipologia CRIS:
1.1 Articolo in rivista
Elenco autori:
Olthof, P. B.; Bouwense, S. A. W.; Bednarsch, J.; Dewulf, M.; Kazemier, G.; Maithel, S.; Jarnagin, W. R.; Aldrighetti, L.; Roberts, K. J.; Troisi, R. I.; Malago, M. M.; Lang, H.; Alikhanov, R.; Ruzzenente, A.; Malik, H.; Charco, R.; Sparrelid, E.; Pratschke, J.; Cescon, M.; Nadalin, S.; Hagendoorn, J.; Schadde, E.; Hoogwater, F. J. H.; Schnitzbauer, A. A.; Topal, B.; Lodge, P.; Olde Damink, S. W. M.; Neumann, U. P.; Groot Koerkamp, B.; Zonderhuis, B. M.; Van Laarhoven, S.; Topal, H.; Sutcliff, R.; Sultana, A.; Serenari, M.; Schmelzle, M.; Rolinger, J.; Ravaioli, M.; Ratti, F.; Quinn, L. M.; Prasad, R.; Porte, R. J.; Poletto, E.; Nota, C. L. M.; Nooijen, L. E.; Nguyen, T. A.; Molenaar, Q. I.; Marino, R.; Margies, R.; Maithel, S. K.; Kingham, T. P.; Jansson, H.; Heil, J.; Hakeem, A.; Van Gulik, T. M.; Guglielmi, A.; Gomez-Gavara, C.; Gilg, S.; Giglio, M. C.; Geers, J.; Franken, L. C.; Erdmann, J. I.; Efanov, M.; Dopazo, C.; De Savornin Lohman, E.; De Reuver, P.; D'Angelica, M. I.; Capobianco, I.; Buettner, S.; De Boer, M. T.; Benzing, C.; Bednarsch, J.; Bechstein, W. O.; Bartlett Dm Bartsch, F.
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