Does Surgical Approach Influence Benchmark Attainment in Intrahepatic Cholangiocarcinoma?
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Gastineau Delphine, Goumard Claire, Doussot Alexandre, Allard Marc-Antoine, Venezia Raphael, Langella Serena, Millet Guillaume, Bustamante Ruth, Hobeika Christian, Rhaiem Rami, Tzedakis Stylianos, Jeddou Heithem, Le Floch Bastien, Valverde Alain, Peru Nicolas, Pessaux Patrick, Giannone Fabio, Mabrut Jean Yves, Mohkam Kayvan, Sa Cunha Antonio, Salloum Chady, Blanc Pierre Yves, Le Roy Bertrand, Kawai Takayuki, Farges Olivier, Hofmeyr Stefan, Fuks David, Truant Stéphanie, Cherqui Daniel, Ferrero Alessandro, Boleslawski Emmanuel, Regimbeau Jean-Marc, Vibert Eric, Sommacale Daniele, Soubrane Olivier, Scatton Olivier, Laurent Alexis, Brustia Raffaele, AFC‐ICC‐2009, AFC‐LLR‐2018, PRS‐2019 and FRIES‐ACHBPT‐2024 Study group
Аннотация
OBJECTIVE: To assess the association between composite surgical benchmark attainment (R0 + LND) and short- and long-term outcomes after ICC resection, stratified per surgical approach.
METHODS: A retrospective multicenter analysis was conducted including 240 patients treated from 2010 to 2024. The primary endpoint was achievement of both R0 resection and LND. Secondary endpoints included 90-day mortality, overall (OS), and disease-free survival (DFS).
RESULTS: Among the 240 included patients 38.8% met surgical benchmarks (R0 + LND), with rates varying by approach: OLR 51.1%, RLR 44.4%, and LLR 14.5% (p < 0.001). 90-day mortality was 5.0% (12/240) overall, with no significant difference between surgical approaches (p = 0.219). One and 3-year overall survival was 79%/30% for OLR, 95%/89% for LLR, and 90%/81% for RLR (p < 0.001). Multivariable analysis identified tumor multiplicity as an independent predictor of mortality (HR = 2.18, p = 0.003), while LLR was independently protective (HR = 0.15, p < 0.001); RLR showed a non-significant protective trend.
CONCLUSION: Although OLR and RLR more frequently met oncological benchmark criteria, only LLR was independently associated with improved overall survival, highlighting a potential disconnect between benchmark adherence and long-term outcomes in ICC.