Analysis of neoadjuvant therapy effect on 30-day postoperative outcomes in gallbladder cancer.

Blood transfusion Gallbladder neoplasms Neoadjuvant therapy Postoperative complications Treatment outcome

Journal

Surgery open science
ISSN: 2589-8450
Titre abrégé: Surg Open Sci
Pays: United States
ID NLM: 101768812

Informations de publication

Date de publication:
Sep 2024
Historique:
received: 02 02 2024
revised: 13 08 2024
accepted: 19 08 2024
medline: 16 9 2024
pubmed: 16 9 2024
entrez: 16 9 2024
Statut: epublish

Résumé

The role of neoadjuvant therapy (NAT) in gallbladder cancer (GBC) is not well established. We sought to evaluate the effect of NAT on postoperative outcomes following surgical resection of GBC. We hypothesized that patients receiving NAT would have similar rates of 30-day mortality, readmission, and postoperative complications (e.g. bile leakage and liver failure) compared to those who did not receive NAT. The 2014-2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Hepatectomy database was queried for patients that underwent surgery for GBC. Propensity scores were calculated to match patients in a 1:2 ratio based on age, comorbidities, functional status, and tumor staging. A total of 37 patients undergoing NAT were matched to 74 patients without NAT. There was no difference in any matched characteristics. Compared to the NAT group, the no NAT cohort had similar rates of postoperative bile leakage (NAT 13.5 % vs. no NAT 10.8 %, In patients undergoing surgical resection for GBC, those with and without NAT had similar rates of readmission and 30-day mortality, however NAT was associated with an increased risk for transfusion. Despite use of a large national database, this study may be underpowered to adequately assess the effect of NAT on perioperative GBC outcomes and thus warrants further investigation.

Sections du résumé

Background UNASSIGNED
The role of neoadjuvant therapy (NAT) in gallbladder cancer (GBC) is not well established. We sought to evaluate the effect of NAT on postoperative outcomes following surgical resection of GBC. We hypothesized that patients receiving NAT would have similar rates of 30-day mortality, readmission, and postoperative complications (e.g. bile leakage and liver failure) compared to those who did not receive NAT.
Methods UNASSIGNED
The 2014-2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Hepatectomy database was queried for patients that underwent surgery for GBC. Propensity scores were calculated to match patients in a 1:2 ratio based on age, comorbidities, functional status, and tumor staging.
Results UNASSIGNED
A total of 37 patients undergoing NAT were matched to 74 patients without NAT. There was no difference in any matched characteristics. Compared to the NAT group, the no NAT cohort had similar rates of postoperative bile leakage (NAT 13.5 % vs. no NAT 10.8 %,
Conclusion UNASSIGNED
In patients undergoing surgical resection for GBC, those with and without NAT had similar rates of readmission and 30-day mortality, however NAT was associated with an increased risk for transfusion. Despite use of a large national database, this study may be underpowered to adequately assess the effect of NAT on perioperative GBC outcomes and thus warrants further investigation.

Identifiants

pubmed: 39279889
doi: 10.1016/j.sopen.2024.08.001
pii: S2589-8450(24)00111-8
pmc: PMC11402315
doi:

Types de publication

Journal Article

Langues

eng

Pagination

17-21

Informations de copyright

© 2024 The Authors.

Déclaration de conflit d'intérêts

We have no conflicts of interest to disclose.

Auteurs

Nicole Martin (N)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Areg Grigorian (A)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Francesca A Kimelman (FA)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Zeljka Jutric (Z)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Stephen Stopenski (S)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

David K Imagawa (DK)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Ron F Wolf (RF)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Shimul Shah (S)

University of Cincinnati, Department of Surgery, 231 Albert Sabin Way, Cincinnati, OH, USA.

Jeffry Nahmias (J)

University of California, Irvine, Department of Surgery, 101 The City Dr S, Orange, CA, USA.

Classifications MeSH