Cargando…

Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study

BACKGROUND: Cholecystectomy, hepatectomy, and lymphadenectomy are recommended as the curative treatment for resectable gallbladder cancer (GBC). Textbook outcomes in liver surgery (TOLS) is a novel composite measure that has been defined by expert consensus to represent the optimal postoperative cou...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Zhi-Peng, Guo, Wei, Yin, Da-Long, Chen, Wei-Yue, Wang, Jiao-Yang, Li, Xue-Lei, Yue, Ping, Yu, Chao, Wu, Zhao-Ping, Ding, Rui, Zhu, Yi, Huang, Fan, Zhou, Jin-Xue, Zhang, Dong, Chen, Wei, Jiang, Yan, Bai, Jie, Wang, Jing-Jing, Zhang, Yan-Qi, Dai, Hai-Su, Lau, Wan Yee, Chen, Zhi-Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498895/
https://www.ncbi.nlm.nih.gov/pubmed/37288584
http://dx.doi.org/10.1097/JS9.0000000000000510
_version_ 1785105618190729216
author Liu, Zhi-Peng
Guo, Wei
Yin, Da-Long
Chen, Wei-Yue
Wang, Jiao-Yang
Li, Xue-Lei
Yue, Ping
Yu, Chao
Wu, Zhao-Ping
Ding, Rui
Zhu, Yi
Huang, Fan
Zhou, Jin-Xue
Zhang, Dong
Chen, Wei
Jiang, Yan
Bai, Jie
Wang, Jing-Jing
Zhang, Yan-Qi
Dai, Hai-Su
Lau, Wan Yee
Chen, Zhi-Yu
author_facet Liu, Zhi-Peng
Guo, Wei
Yin, Da-Long
Chen, Wei-Yue
Wang, Jiao-Yang
Li, Xue-Lei
Yue, Ping
Yu, Chao
Wu, Zhao-Ping
Ding, Rui
Zhu, Yi
Huang, Fan
Zhou, Jin-Xue
Zhang, Dong
Chen, Wei
Jiang, Yan
Bai, Jie
Wang, Jing-Jing
Zhang, Yan-Qi
Dai, Hai-Su
Lau, Wan Yee
Chen, Zhi-Yu
author_sort Liu, Zhi-Peng
collection PubMed
description BACKGROUND: Cholecystectomy, hepatectomy, and lymphadenectomy are recommended as the curative treatment for resectable gallbladder cancer (GBC). Textbook outcomes in liver surgery (TOLS) is a novel composite measure that has been defined by expert consensus to represent the optimal postoperative course after hepatectomy. This study aimed to determine the incidence of TOLS and the independent predictors associated with TOLS after curative-intent resection in GBC patients. METHODS: All consecutive GBC patients who underwent curative-intent resection between 2014 and 2020 were enrolled from a multicenter database from 11 hospitals as the training and the internal testing cohorts, and Southwest Hospital as the external testing cohort. TOLS was defined as no intraoperative grade greater than or equal to 2 incidents, no grade B/C postoperative bile leaks, no postoperative grade B/C liver failure, no 90-day postoperative major morbidity, no 90-day readmission, no 90-day mortality after hospital discharge, and R0 resection. Independent predictors of TOLS were identified using logistic regression and were used to construct the nomogram. The predictive performance was assessed using the area under the curve and calibration curves. RESULTS: TOLS was achieved in 168 patients (54.4%) and 74 patients (57.8%) from the training and internal testing cohorts, and the external testing cohort, respectively. On multivariate analyses, age less than or equal to 70 years, absence of preoperative jaundice (total bilirubin≤3 mg/dl), T1 stage, N0 stage, wedge hepatectomy, and no neoadjuvant therapy were independently associated with TOLS. The nomogram that incorporated these predictors demonstrated excellent calibration and good performance in both the training and external testing cohorts (area under the curve: 0.741 and 0.726). CONCLUSIONS: TOLS was only achieved in approximately half of GBC patients treated with curative-intent resection, and the constructed nomogram predicted TOLS accurately.
format Online
Article
Text
id pubmed-10498895
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-104988952023-09-14 Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study Liu, Zhi-Peng Guo, Wei Yin, Da-Long Chen, Wei-Yue Wang, Jiao-Yang Li, Xue-Lei Yue, Ping Yu, Chao Wu, Zhao-Ping Ding, Rui Zhu, Yi Huang, Fan Zhou, Jin-Xue Zhang, Dong Chen, Wei Jiang, Yan Bai, Jie Wang, Jing-Jing Zhang, Yan-Qi Dai, Hai-Su Lau, Wan Yee Chen, Zhi-Yu Int J Surg Original Research BACKGROUND: Cholecystectomy, hepatectomy, and lymphadenectomy are recommended as the curative treatment for resectable gallbladder cancer (GBC). Textbook outcomes in liver surgery (TOLS) is a novel composite measure that has been defined by expert consensus to represent the optimal postoperative course after hepatectomy. This study aimed to determine the incidence of TOLS and the independent predictors associated with TOLS after curative-intent resection in GBC patients. METHODS: All consecutive GBC patients who underwent curative-intent resection between 2014 and 2020 were enrolled from a multicenter database from 11 hospitals as the training and the internal testing cohorts, and Southwest Hospital as the external testing cohort. TOLS was defined as no intraoperative grade greater than or equal to 2 incidents, no grade B/C postoperative bile leaks, no postoperative grade B/C liver failure, no 90-day postoperative major morbidity, no 90-day readmission, no 90-day mortality after hospital discharge, and R0 resection. Independent predictors of TOLS were identified using logistic regression and were used to construct the nomogram. The predictive performance was assessed using the area under the curve and calibration curves. RESULTS: TOLS was achieved in 168 patients (54.4%) and 74 patients (57.8%) from the training and internal testing cohorts, and the external testing cohort, respectively. On multivariate analyses, age less than or equal to 70 years, absence of preoperative jaundice (total bilirubin≤3 mg/dl), T1 stage, N0 stage, wedge hepatectomy, and no neoadjuvant therapy were independently associated with TOLS. The nomogram that incorporated these predictors demonstrated excellent calibration and good performance in both the training and external testing cohorts (area under the curve: 0.741 and 0.726). CONCLUSIONS: TOLS was only achieved in approximately half of GBC patients treated with curative-intent resection, and the constructed nomogram predicted TOLS accurately. Lippincott Williams & Wilkins 2023-06-05 /pmc/articles/PMC10498895/ /pubmed/37288584 http://dx.doi.org/10.1097/JS9.0000000000000510 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Original Research
Liu, Zhi-Peng
Guo, Wei
Yin, Da-Long
Chen, Wei-Yue
Wang, Jiao-Yang
Li, Xue-Lei
Yue, Ping
Yu, Chao
Wu, Zhao-Ping
Ding, Rui
Zhu, Yi
Huang, Fan
Zhou, Jin-Xue
Zhang, Dong
Chen, Wei
Jiang, Yan
Bai, Jie
Wang, Jing-Jing
Zhang, Yan-Qi
Dai, Hai-Su
Lau, Wan Yee
Chen, Zhi-Yu
Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title_full Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title_fullStr Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title_full_unstemmed Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title_short Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
title_sort textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498895/
https://www.ncbi.nlm.nih.gov/pubmed/37288584
http://dx.doi.org/10.1097/JS9.0000000000000510
work_keys_str_mv AT liuzhipeng textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT guowei textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT yindalong textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT chenweiyue textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT wangjiaoyang textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT lixuelei textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT yueping textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT yuchao textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT wuzhaoping textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT dingrui textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT zhuyi textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT huangfan textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT zhoujinxue textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT zhangdong textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT chenwei textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT jiangyan textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT baijie textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT wangjingjing textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT zhangyanqi textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT daihaisu textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT lauwanyee textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy
AT chenzhiyu textbookoutcomesinliversurgeryforgallbladdercancerpatientstreatedwithcurativeintentresectionamulticenterobservationalstudy