Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

BACKGROUND 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 identif...

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Published in:Cancer 2015-08, Vol.121 (16), p.2730-2739
Main 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.
Format: Article
Language:English
Subjects:
Aged
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - surgery
Bile Ducts, Intrahepatic - surgery
Cholangiocarcinoma - mortality
Cholangiocarcinoma - surgery
complications
Female
Humans
intrahepatic cholangiocarcinoma
Male
Middle Aged
Morbidity
Postoperative Complications - mortality
recurrence
survival
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Summary:BACKGROUND 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. METHODS 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. RESULTS 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 [P = .01]) and severity of complications (major vs none: HR, 1.55; 95% CI, 1.14‐2.11 [P = .01]; minor vs none: HR, 1.30; 95% CI, 0.99‐1.70 [P = .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 [P
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29419