Liver transplantation as a new standard of care in patients with perihilar cholangiocarcinoma?
| العنوان: | Liver transplantation as a new standard of care in patients with perihilar cholangiocarcinoma? |
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| المؤلفون: | Eva Breuer, Matteo Mueller, Majella B. Doyle, Liu Yang, Sarwa Darwish Murad, Imran J. Anwar, Shaheed Merani, Ashley Limkemann, Heithem Jeddou, Steven C. Kim, Victor López-López, Ahmed Nassar, Frederik J.H. Hoogwater, Eric Vibert, Michelle L. De Oliveira, Daniel Cherqui, Robert J. Porte, Joseph F. Magliocca, Lutz Fischer, Constantino Fondevila, Krzysztof Zieniewicz, Pablo Ramírez, David P. Foley, Karim Boudjema, Austin D. Schenk, Alan N. Langnas, Stuart Knechtle, Wojciech G. Polak, C. Burcin Taner, William C. Chapman, Charles B. Rosen, Gregory J. Gores, Philipp Dutkowski, Julie K. Heimbach, Pierre-Alain Clavien |
| المساهمون: | Gastroenterology & Hepatology, Surgery, Groningen Institute for Organ Transplantation (GIOT) |
| المصدر: | Annals of Surgery, 276(5), 846-853. Lippincott Williams & Wilkins Annals of Surgery, 276(5), 846-853. LIPPINCOTT WILLIAMS & WILKINS |
| بيانات النشر: | LIPPINCOTT WILLIAMS & WILKINS, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Complications, Liver transplantation, CCI, Benchmarks, Standard of Care, Outcomes, Mayo-protocol, Cholangiocarcinoma, Benchmarking, Bile Duct Neoplasms, Humans, Surgery, Perihilar cholangiocarcinoma, Klatskin Tumor |
| الوصف: | Objective: To define benchmark values for liver transplantation (LT) in patients with perihilar cholangiocarcinoma (PHC) enabling unbiased comparisons.Background: Transplantation for PHC is used with reluctance in many centers and even contraindicated in several countries. Although benchmark values for LT are available, there is a lack of specific data on LT performed for PHC.Methods: PHC patients considered for LT after Mayo-like protocol were analyzed in 17 reference centers in 2 continents over the recent 5-year period (2014–2018). The minimum follow-up was 1 year. Benchmark patients were defined as operated at high-volume centers (≥ 50 overall LT/year) after neoadjuvant chemoradiotherapy, with a tumor diameter Results: One hundred thirty-four consecutive patients underwent LT after completion of the neoadjuvant treatment. Of those, 89.6% qualified as benchmark cases. Benchmark cutoffs were 90-day mortality ≤ 5.2%; comprehensive complication index at 1 year of ≤ 33.7; grade ≥ 3 complication rates ≤ 66.7%. These values were better than benchmark values for other indications of LT. Five-year disease-free survival was largely superior compared with a matched group of nodal negative patients undergoing curative liver resection (n = 106) (62% vs 32%, P < 0.001).Conclusion: This multicenter benchmark study demonstrates that LT offers excellent outcomes with superior oncological results in early stage PHC patients, even in candidates for surgery. This provocative observation should lead to a change in available therapeutic algorithms for PHC. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0003-4932 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::69304643daa56d68636dc8a5f610c900 https://doi.org/10.1097/SLA.0000000000005641 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....69304643daa56d68636dc8a5f610c900 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00034932 |
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