Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
12 Jan 2024
Historique:
received: 06 11 2023
accepted: 21 12 2023
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 12 1 2024
Statut: aheadofprint

Résumé

Benchmarking in surgery has been proposed as a means to compare results across institutions to establish best practices. We sought to define benchmark values for hepatectomy for intrahepatic cholangiocarcinoma (ICC) across an international population. Patients who underwent liver resection for ICC between 1990 and 2020 were identified from an international database, including 14 Eastern and Western institutions. Patients operated on at high-volume centers who had no preoperative jaundice, ASA class <3, body mass index <35 km/m Among 1193 patients who underwent curative-intent hepatectomy for ICC, 600 (50.3%) were included in the benchmark group. Among benchmark patients, median age was 58.0 years (interquartile range [IQR] 49.0-67.0), only 28 (4.7%) patients received neoadjuvant therapy, and most patients had a minor resection (n = 499, 83.2%). Benchmark values included ≥3 lymph nodes retrieved when lymphadenectomy was performed, blood loss ≤600 mL, perioperative blood transfusion rate ≤42.9%, and operative time ≤339 min. The postoperative benchmark values included TOO achievement ≥59.3%, positive resection margin ≤27.5%, 30-day readmission ≤3.6%, Clavien-Dindo III or more complications ≤14.3%, and 90-day mortality ≤4.8%, as well as hospital stay ≤14 days. Benchmark cutoffs targeting short-term perioperative outcomes can help to facilitate comparisons across hospitals performing liver resection for ICC, assess inter-institutional variation, and identify the highest-performing centers to improve surgical and oncologic outcomes.

Identifiants

pubmed: 38214817
doi: 10.1245/s10434-023-14880-8
pii: 10.1245/s10434-023-14880-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Lauterio A, De Carlis R, Centonze L, et al. Current surgical management of peri-hilar and intra-hepatic cholangiocarcinoma. Cancers (Basel). 2021;13(15):3657.
doi: 10.3390/cancers13153657 pubmed: 34359560 pmcid: 8345178
Dondossola D, Ghidini M, Grossi F, Rossi G, Foschi D. Practical review for diagnosis and clinical management of perihilar cholangiocarcinoma. World J Gastroenterol. 2020;26(25):3542–61.
doi: 10.3748/wjg.v26.i25.3542 pubmed: 32742125 pmcid: 7366054
Valle JW, Kelley RK, Nervi B, Oh DY, Zhu AX. Biliary tract cancer. Lancet. 2021;397(10272):428–44.
doi: 10.1016/S0140-6736(21)00153-7 pubmed: 33516341
Bridgewater J, Galle PR, Khan SA, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol. 2014;60(6):1268–89.
doi: 10.1016/j.jhep.2014.01.021 pubmed: 24681130
Valle J, Wasan H, Palmer DH, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.
doi: 10.1056/NEJMoa0908721 pubmed: 20375404
de Jong MC, Nathan H, Sotiropoulos GC, et al. Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol. 2011;29(23):3140–5.
doi: 10.1200/JCO.2011.35.6519 pubmed: 21730269
Endo I, Gonen M, Yopp AC, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg. 2008;248(1):84–96.
doi: 10.1097/SLA.0b013e318176c4d3 pubmed: 18580211
Parina RP, Chang DC, Rose JA, Talamini MA. Is a low readmission rate indicative of a good hospital? J Am Coll Surg. 2015;220(2):169–76.
doi: 10.1016/j.jamcollsurg.2014.10.020 pubmed: 25529903
Kneuertz PJ, Pitt HA, Bilimoria KY, et al. Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg. 2012;16(9):1727–35.
doi: 10.1007/s11605-012-1938-y pubmed: 22760965
Alaimo L, Moazzam Z, Lima HA, et al. An attempt to establish and apply global benchmarks for liver resection of malignant hepatic tumors. Surgery. 2023;174(6):1384–92.
doi: 10.1016/j.surg.2023.08.024 pubmed: 37741777
Merath K, Chen Q, Bagante F, et al. Textbook outcomes among medicare patients undergoing hepatopancreatic surgery. Ann Surg. 2020;271(6):1116–23.
doi: 10.1097/SLA.0000000000003105 pubmed: 30499800
Gero D, Muller X, Staiger RD, et al. How to establish benchmarks for surgical outcomes?: A checklist based on an international expert delphi consensus. Ann Surg. 2022;275(1):115–20.
doi: 10.1097/SLA.0000000000003931 pubmed: 32398485
Rossler F, Sapisochin G, Song G, et al. Defining benchmarks for major liver surgery: a multicenter analysis of 5202 living liver donors. Ann Surg. 2016;264(3):492–500.
doi: 10.1097/SLA.0000000000001849 pubmed: 27433909
Vega EA, Newhook TE, Mellado S, et al. Benchmarks and geographic differences in gallbladder cancer surgery: an international multicenter study. Ann Surg Oncol. 2023;30(8):4904–11.
doi: 10.1245/s10434-023-13531-2 pubmed: 37149547
Mueller M, Breuer E, Mizuno T, et al. Perihilar cholangiocarcinoma - novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann Surg. 2021;274(5):780–8.
doi: 10.1097/SLA.0000000000005103 pubmed: 34334638
Clavien PA, Puhan MA. Measuring and achieving the best possible outcomes in surgery. Br J Surg. 2017;104(9):1121–2.
doi: 10.1002/bjs.10569 pubmed: 28488801
Goh BKP, Han HS, Chen KH, et al. Defining global benchmarks for laparoscopic liver resections: an international multicenter study. Ann Surg. 2023;277(4):e839–48.
doi: 10.1097/SLA.0000000000005530 pubmed: 35837974
Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477–81.
doi: 10.1056/NEJMp1011024 pubmed: 21142528
Nagino M, DeMatteo R, Lang H, et al. Proposal of a new comprehensive notation for hepatectomy: the “new world” terminology. Ann Surg. 2021;274(1):1–3.
doi: 10.1097/SLA.0000000000004808 pubmed: 33630445
Pang YY. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000; 2:333-39. HPB (Oxford). 2002;4(2):99; author reply 99-100.
Sasaki K, Morioka D, Conci S, et al. The tumor burden score: a new “metro-ticket” prognostic tool for colorectal liver metastases based on tumor size and number of tumors. Ann Surg. 2018;267(1):132–41.
doi: 10.1097/SLA.0000000000002064 pubmed: 27763897
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.
doi: 10.1097/01.sla.0000133083.54934.ae pubmed: 15273542 pmcid: 1360123
Staiger RD, Schwandt H, Puhan MA, Clavien PA. Improving surgical outcomes through benchmarking. Br J Surg. 2019;106(1):59–64.
doi: 10.1002/bjs.10976 pubmed: 30485405
van Buuren S, Boshuizen HC, Knook DL. Multiple imputation of missing blood pressure covariates in survival analysis. Stat Med. 1999;18(6):681–94.
doi: 10.1002/(SICI)1097-0258(19990330)18:6<681::AID-SIM71>3.0.CO;2-R pubmed: 10204197
Barkun J, Clavien P, Pawlik TM. The benefits of benchmarking-a new perspective on measuring quality in surgery. JAMA Surg. 2023;158(4):341–2.
doi: 10.1001/jamasurg.2022.5831 pubmed: 36696097
von Eiff W. International benchmarking and best practice management: in search of health care and hospital excellence. Adv Health Care Manag. 2015;17:223–52.
doi: 10.1108/S1474-823120140000017014
Russolillo N, Aldrighetti L, Cillo U, et al. Risk-adjusted benchmarks in laparoscopic liver surgery in a national cohort. Br J Surg. 2020;107(7):845–53.
doi: 10.1002/bjs.11404 pubmed: 31925777
Fiorentini G, Essaji Y, Geller DA, et al. Textbook outcomes and benchmarks of minimally invasive left lateral sectionectomy across North America. Surg Endosc. 2023;37(4):2980–6.
doi: 10.1007/s00464-022-09780-z pubmed: 36513782
Hobeika C, Fuks D, Cauchy F, et al. Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers. J Hepatol. 2020;73(5):1100–8.
doi: 10.1016/j.jhep.2020.05.003 pubmed: 32407812
Raptis DA, Linecker M, Kambakamba P, et al. Defining benchmark outcomes for ALPPS. Ann Surg. 2019;270(5):835–41.
doi: 10.1097/SLA.0000000000003539 pubmed: 31592812
Muller X, Marcon F, Sapisochin G, et al. Defining benchmarks in liver transplantation: a multicenter outcome analysis determining best achievable results. Ann Surg. 2018;267(3):419–25.
doi: 10.1097/SLA.0000000000002477 pubmed: 28885508
Chen Q, Beal EW, Kimbrough CW, et al. Perioperative complications and the cost of rescue or failure to rescue in hepato-pancreato-biliary surgery. HPB (Oxford). 2018;20(9):854–64.
doi: 10.1016/j.hpb.2018.03.010 pubmed: 29691125
Gurusamy KS, Pamecha V, Sharma D, Davidson BR. Techniques for liver parenchymal transection in liver resection. Cochrane Database Syst Rev. 2009;1:CD006880.
Moggia E, Rouse B, Simillis C, et al. Methods to decrease blood loss during liver resection: a network meta-analysis. Cochrane Database Syst Rev. 2016;10(10):CD10683.
Shiraiwa DK, Carvalho P, Maeda CT, et al. The role of minimally invasive hepatectomy for hilar and intrahepatic cholangiocarcinoma: a systematic review of the literature. J Surg Oncol. 2020;121(5):863–72.
doi: 10.1002/jso.25821 pubmed: 31902142
Moazzam Z, Alaimo L, Endo Y, Lima HA, Pawlik TM. Predictors, patterns, and impact of adequate lymphadenectomy in intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2023;30(4):1966–77.
doi: 10.1245/s10434-022-13044-4 pubmed: 36622527
Endo Y, Moazzam Z, Lima HA, et al. The impact of tumor location on the value of lymphadenectomy for intrahepatic cholangiocarcinoma. HPB (Oxford). 2023;25(6):650–8.
doi: 10.1016/j.hpb.2023.02.013 pubmed: 36894491
Weber SM, Ribero D, O’Reilly EM, Kokudo N, Miyazaki M, Pawlik TM. Intrahepatic cholangiocarcinoma: expert consensus statement. HPB (Oxford). 2015;17(8):669–80.
doi: 10.1111/hpb.12441 pubmed: 26172134 pmcid: 4527852
van Doorslaer E, Masseria C, Koolman X, Group OHER. Inequalities in access to medical care by income in developed countries. CMAJ. 2006;174(2):177–83.
doi: 10.1503/cmaj.050584 pubmed: 16415462 pmcid: 1329455
Alaimo L, Moazzam Z, Endo Y, et al. The application of artificial intelligence to investigate long-term outcomes and assess optimal margin width in hepatectomy for intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2023;30(7):4292–301.
doi: 10.1245/s10434-023-13349-y pubmed: 36952150
Endo Y, Sasaki K, Moazzam Z, et al. Higher tumor burden status dictates the impact of surgical margin status on overall survival in patients undergoing resection of intrahepatic cholangiocarcinoma. Ann Surg Oncol. 2022;30(4):2023–32.
doi: 10.1245/s10434-022-12803-7 pubmed: 36396868

Auteurs

Laura Alaimo (L)

Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Department of Surgery, University of Verona, Verona, Italy.

Yutaka Endo (Y)

Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.

Giovanni Catalano (G)

Department of Surgery, University of Verona, Verona, Italy.

Andrea Ruzzenente (A)

Department of Surgery, University of Verona, Verona, Italy.

Luca Aldrighetti (L)

Department of Surgery, Ospedale San Raffaele, Milan, Italy.

Matthew Weiss (M)

Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.

Todd W Bauer (TW)

Department of Surgery, University of Virginia, Charlottesville, VA, USA.

Sorin Alexandrescu (S)

Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.

George A Poultsides (GA)

Department of Surgery, Stanford University, Stanford, CA, USA.

Shishir K Maithel (SK)

Department of Surgery, Emory University, Atlanta, GA, USA.

Hugo P Marques (HP)

Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.

Guillaume Martel (G)

Department of Surgery, University of Ottawa, Ottawa, ON, Canada.

Carlo Pulitano (C)

Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.

Feng Shen (F)

Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.

François Cauchy (F)

Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France.

Bas Groot Koerkamp (BG)

Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Itaru Endo (I)

Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan.

Minoru Kitago (M)

Department of Surgery, Keio University, Tokyo, Japan.

Timothy M Pawlik (TM)

Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. tim.pawlik@osumc.edu.

Classifications MeSH