Anais Palen1, Jonathan Garnier2, Christian Hobeika3, Jacques Ewald2, Emilie Gregoire4, Jean-Robert Delpero2, Yves P Le Treut4, Olivier Turrini5, Jean Hardwigsen4. 1. Department of General Surgery and Liver Transplantation, La Timone Hospital, Aix Marseille University, Marseille, France. Electronic address: palenanais@gmail.com. 2. Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France. 3. Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France. 4. Department of General Surgery and Liver Transplantation, La Timone Hospital, Aix Marseille University, Marseille, France. 5. Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille University, CRCM, Marseille, France.
Abstract
BACKGROUND: This study aimed to investigate the short- and long-terms outcomes of patients undergoing major hepatectomy (MH) with inferior vena cava (IVC) resection for intrahepatic cholangiocarcinoma (ICC). METHODS: Data from all patients who underwent MH for ICC with or without IVC resection between 2010 and 2018 were analysed retrospectively. Postoperative outcomes, overall survival (OS), and recurrence-free survival (RFS) were compared in the whole population. A propensity score matching (PSM) analysis and an inverse probability weighting analysis (IPW) were performed to assess the influence of IVC resection on short- and long-terms outcomes. RESULTS: Among the 78 patients who underwent MH, 20 had IVC resection (IVC patients). Overall, the mortality and severe complication rate were 8% and 20%, respectively. IVC patients required more extended hepatectomies (p = 0.001) and had increased rates of transfusions (p = 0.001), however they did not experience increased postoperative morbidity, even after PSM. The 1-, 3- and 5-years OS and DFS were 78%, 45%, and 32% and 48%, 20%, and 16%, respectively. IVC was not associated with decreased OS (p = 0.52) and/or RFS (p = 0.85), even after IPW. CONCLUSION: MH with IVC resection for ICC seems to provide acceptable short- and long-term results in a selected population of patients.
BACKGROUND: This study aimed to investigate the short- and long-terms outcomes of patients undergoing major hepatectomy (MH) with inferior vena cava (IVC) resection for intrahepatic cholangiocarcinoma (ICC). METHODS: Data from all patients who underwent MH for ICC with or without IVC resection between 2010 and 2018 were analysed retrospectively. Postoperative outcomes, overall survival (OS), and recurrence-free survival (RFS) were compared in the whole population. A propensity score matching (PSM) analysis and an inverse probability weighting analysis (IPW) were performed to assess the influence of IVC resection on short- and long-terms outcomes. RESULTS: Among the 78 patients who underwent MH, 20 had IVC resection (IVC patients). Overall, the mortality and severe complication rate were 8% and 20%, respectively. IVC patients required more extended hepatectomies (p = 0.001) and had increased rates of transfusions (p = 0.001), however they did not experience increased postoperative morbidity, even after PSM. The 1-, 3- and 5-years OS and DFS were 78%, 45%, and 32% and 48%, 20%, and 16%, respectively. IVC was not associated with decreased OS (p = 0.52) and/or RFS (p = 0.85), even after IPW. CONCLUSION: MH with IVC resection for ICC seems to provide acceptable short- and long-term results in a selected population of patients.
Authors: Stijn Franssen; Kevin C Soares; Joshua Samuel Jolissaint; Diamantis I Tsilimigras; Stefan Buettner; Sorin Alexandrescu; Hugo Marques; Jorge Lamelas; Luca Aldrighetti; T Clark Gamblin; Shishir K Maithel; Carlo Pulitano; Georgios A Margonis; Matthew J Weiss; Todd W Bauer; Feng Shen; George A Poultsides; James Wallis Marsh; Andrea Cercek; Nancy Kemeny; T Peter Kingham; Michael D'Angelica; Timothy M Pawlik; William R Jarnagin; Bas Groot Koerkamp Journal: JAMA Surg Date: 2022-07-01 Impact factor: 16.681