Textbook oncologic outcomes and regionalization among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Background and Objectives Textbook oncologic outcome (TOO) and its association with regionalization of care for intrahepatic cholangiocarcinoma (ICC) have not been evaluated. Methods We identified patients who underwent hepatic resection for ICC between 2004 and 2018 from the National Cancer Databas...

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Bibliographic Details
Published in:Journal of surgical oncology 2023-01, Vol.127 (1), p.81-89
Main Authors: Munir, Muhammad M., Alaimo, Laura, Moazzam, Zorays, Endo, Yutaka, Lima, Henrique A., Shaikh, Chanza, Ejaz, Aslam, Beane, Joal, Dillhoff, Mary, Cloyd, Jordan, Pawlik, Timothy M.
Format: Article
Language:English
Subjects:
Bile Duct Neoplasms - pathology
Bile Ducts, Intrahepatic - surgery
Cholangiocarcinoma
Cholangiocarcinoma - pathology
Hepatectomy
Hepatobiliary
high‐volume hospitals
Humans
intrahepatic cholangiocarcinoma
low‐volume hospitals
Lymph Node Excision
Retrospective Studies
textbook oncologic outcome
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Summary:Background and Objectives Textbook oncologic outcome (TOO) and its association with regionalization of care for intrahepatic cholangiocarcinoma (ICC) have not been evaluated. Methods We identified patients who underwent hepatic resection for ICC between 2004 and 2018 from the National Cancer Database. Facilities were categorized by annual hepatectomy volume for ICC. TOO was defined as no 90‐day mortality, margin‐negative resection, no prolonged hospitalization, no 30‐day readmission, receipt of appropriate adjuvant therapy, and adequate lymphadenectomy. Multivariable regression was used to evaluate the association between annual hepatectomy volume and TOO. Results A total of 5359 patients underwent liver resection for ICC. TOO was achieved in 11.2% (n = 599) of patients. Inadequate lymphadenectomy was the largest impediment to achieving TOO. After adjusting for patient, pathologic, and facility characteristics, high volume facilities had 67% increased odds of achieving TOO (Ref.: low volume; high volume: odds ratio 1.67, 95% confidence interval: 1.24–2.25; p 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.27102