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Postoperative Infectious Complications Worsen Long-Term Survival After Curative-Intent Resection for Hepatocellular Carcinoma.
Wei, Tao; Zhang, Xu-Feng; Bagante, Fabio; Ratti, Francesca; Marques, Hugo P; Silva, Silvia; Soubrane, Olivier; Lam, Vincent; Poultsides, George A; Popescu, Irinel; Grigorie, Razvan; Alexandrescu, Sorin; Martel, Guillaume; Workneh, Aklile; Guglielmi, Alfredo; Hugh, Tom; Aldrighetti, Luca; Endo, Itaru; Pawlik, Timothy M.
Afiliação
  • Wei T; Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Zhang XF; Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Bagante F; Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Ratti F; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  • Marques HP; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  • Silva S; Department of Surgery, University of Verona, Verona, Italy.
  • Soubrane O; Department of Surgery, Ospedale San Raffaele, Milan, Italy.
  • Lam V; Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
  • Poultsides GA; Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
  • Popescu I; Department of Hepatobiliopancreatic Surgery, Beaujon Hospital, Clichy, France.
  • Grigorie R; Department of Surgery, Westmead Hospital, Sydney, Australia.
  • Alexandrescu S; Department of Surgery, Stanford University, Stanford, CA, USA.
  • Martel G; Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
  • Workneh A; Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
  • Guglielmi A; Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
  • Hugh T; Department of Surgery, University of Ottawa, Ottawa, Canada.
  • Aldrighetti L; Department of Surgery, University of Ottawa, Ottawa, Canada.
  • Endo I; Department of Surgery, University of Verona, Verona, Italy.
  • Pawlik TM; Department of Surgery, The University of Sydney, School of Medicine, Sydney, Australia.
Ann Surg Oncol ; 29(1): 315-324, 2022 Jan.
Article em En | MEDLINE | ID: mdl-34378089
BACKGROUND: Postoperative infectious complications may be associated with a worse long-term prognosis for patients undergoing surgery for a malignant indication. The current study aimed to characterize the impact of postoperative infectious complications on long-term oncologic outcomes among patients undergoing resection for hepatocellular carcinoma (HCC). METHODS: Patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. The relationship between postoperative infectious complications, overall survival (OS), and recurrence-free survival (RFS) was analyzed. RESULTS: Among 734 patients who underwent HCC resection, 269 (36.6%) experienced a postoperative complication (Clavien-Dindo grade 1 or 2 [n = 197, 73.2%] vs grade 3 and 4 [n = 69, 25.7%]). An infectious complication was noted in 81 patients (11.0%) and 188 patients (25.6%) had non-infectious complications. The patients with infectious complications had worse OS (median: infectious complications [46.5 months] vs no complications [106.4 months] [p < 0.001] and non-infectious complications [85.7 months] [p < 0.05]) and RFS (median: infectious complications [22.1 months] vs no complications [45.5 months] [p < 0.05] and non-infectious complications [38.3 months] [p = 0.139]) than the patients who had no complication or non-infectious complications. In the multivariable analysis, infectious complications remained an independent risk factor for OS (hazard ratio [HR], 1.7; p = 0.016) and RFS (HR, 1.6; p = 0.013). Among the patients with infectious complications, patients with non-surgical-site infection (SSI) had even worse OS and RFS than patients with SSI (median OS: 19.5 vs 70.9 months [p = 0.010]; median RFS: 12.8 vs 33.9 months [p = 0.033]). CONCLUSION: Infectious complications were independently associated with an increased long-term risk of tumor recurrence and death. Patients with non-SSI versus SSI had a particularly worse oncologic outcome.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Transmissíveis / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Transmissíveis / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article