Short- and Long-Term Outcomes of Liver Resection for Intrahepatic Cholangiocarcinoma Associated with the Metabolic Syndrome. View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-04

AUTHORS

Christian Hobeika, François Cauchy, Nicolas Poté, Pierre-Emmanuel Rautou, François Durand, Olivier Farges, Safi Dokmak, Valérie Vilgrain, Maxime Ronot, Valérie Paradis, Olivier Soubrane

ABSTRACT

BACKGROUND: While the metabolic syndrome (MS) is being recognized as an important risk factor for intrahepatic cholangiocarcinoma (ICC), the outcomes of liver resection in this context remain poorly described. This study aims to report the short- and long-term results of hepatectomy for patients with MS as risk factor for the development of ICC (MS+). METHODS: All patients undergoing hepatectomy for ICC between 2000 and 2016 at a single center were retrospectively analyzed. The perioperative outcomes of MS+ and ICC patients without MS (MS-) were compared. RESULTS: Among 115 resected ICC patients, 40 (34.8%) were MS+ and 75 (65.2%) were MS-. MS+ exhibited an increased Charlson comorbidity index (5 ± 2 vs. 2 ± 2, p < 0.001) than MS- patients. While operative characteristics did not differ significantly between the 2 groups, MS+ experienced higher rate of major complications (62.5 vs. 29.3%, p = 0.001). On multivariate analysis, MS+ was an independent risk factor of major complication (HR 2.86, 95% CI 1.07-7.60, p = 0.036) and major cardiorespiratory complication (HR 4.35, 95% CI 1.50-12.62, p = 0.007). Pathological analysis revealed that MS+ displayed higher rates of non-alcoholic fatty liver disease (60.0 vs. 31.1%, p = 0.003) and non-alcoholic steatohepatitis (25 vs. 5.4%, p = 0.005). MS+ was independently associated with decreased risk of recurrence (HR 0.47, 95% CI 0.26-0.85, p = 0.001). CONCLUSIONS: MS+ accounts for 35% of resected ICC patients. The existence of significant cardiovascular comorbidities increases postoperative morbidity and requires specific management. More... »

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-019-04996-y

DOI

http://dx.doi.org/10.1007/s00268-019-04996-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113185180

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30949764


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