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Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases:a nationwide cohort study

Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases:a nationwide cohort study

Authors :
de Graaff, Michelle R.
Klaase, Joost M.
den Dulk, Marcel
te Riele, Wouter W.
Hagendoorn, Jeroen
van Heek, N. Tjarda
Vermaas, M.
Belt, Eric J.Th
Bosscha, Koop
Slooter, Gerrit D.
Leclercq, Wouter K.G.
Liem, Mike S.L.
Mieog, J. Sven D.
Swijnenburg, Rutger Jan
van Dam, Ronald M.
Verhoef, Cees
Kuhlmann, Koert
van Duijvendijk, Peter
Gerhards, Michael F.
Gobardhan, Paul
van den Boezem, Peter
Manusama, Eric R.
Grünhagen, Dirk J.
Kok, Niels F.M.
Torrenga, Hans
de Graaff, Michelle R.
Klaase, Joost M.
den Dulk, Marcel
te Riele, Wouter W.
Hagendoorn, Jeroen
van Heek, N. Tjarda
Vermaas, M.
Belt, Eric J.Th
Bosscha, Koop
Slooter, Gerrit D.
Leclercq, Wouter K.G.
Liem, Mike S.L.
Mieog, J. Sven D.
Swijnenburg, Rutger Jan
van Dam, Ronald M.
Verhoef, Cees
Kuhlmann, Koert
van Duijvendijk, Peter
Gerhards, Michael F.
Gobardhan, Paul
van den Boezem, Peter
Manusama, Eric R.
Grünhagen, Dirk J.
Kok, Niels F.M.
Torrenga, Hans
Source :
de Graaff , M R , Klaase , J M , Dutch Hepato Biliary Audit Group, Collaborators , den Dulk , M , te Riele , W W , Hagendoorn , J , van Heek , N T , Vermaas , M , Belt , E J T , Bosscha , K , Slooter , G D , Leclercq , W K G , Liem , M S L , Mieog , J S D , Swijnenburg , R J , van Dam , R M , Verhoef , C , Kuhlmann , K , van Duijvendijk , P , Gerhards , M F , Gobardhan , P , van den Boezem , P , Manusama , E R , Grünhagen , D J , Kok , N F M & Torrenga , H 2024 , ' Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases : a nationwide cohort study ' , HPB , vol. 26 , no. 6 , pp. 789-799 .
Publication Year :
2024

Abstract

Background: Approximately 70% of patients with colorectal liver metastases (CRLM) experiences intrahepatic recurrence after initial liver resection. This study assessed outcomes and hospital variation in repeat liver resections (R-LR).Methods: This population-based study included all patients who underwent liver resection for CRLM between 2014 and 2022 in the Netherlands. Overall survival (OS) was collected for patients operated on between 2014 and 2018 by linkage to the insurance database. Results: Data of 7479 liver resections (1391 (18.6%) repeat and 6088 (81.4%) primary) were analysed. Major morbidity and mortality were not different. Factors associated with major morbidity included ASA 3+, major liver resection, extrahepatic disease, and open surgery. Five-year OS after repeat versus primary liver resection was 42.3% versus 44.8%, P = 0.37. Factors associated with worse OS included largest CRLM >5 cm (aHR 1.58, 95% CI: 1.07–2.34, P = 0.023), >3 CRLM (aHR 1.33, 95% CI: 1.00–1.75, P = 0.046), extrahepatic disease (aHR 1.60, 95% CI: 1.25–2.04, P = 0.001), positive tumour margins (aHR 1.42, 95% CI: 1.09–1.85, P = 0.009). Significant hospital variation in performance of R-LR was observed, median 18.9% (8.2% to 33.3%).Conclusion: Significant hospital variation was observed in performance of R-LR in the Netherlands reflecting different treatment decisions upon recurrence. On a population-based level R-LR leads to satisfactory survival.

Details

Database :
OAIster
Journal :
de Graaff , M R , Klaase , J M , Dutch Hepato Biliary Audit Group, Collaborators , den Dulk , M , te Riele , W W , Hagendoorn , J , van Heek , N T , Vermaas , M , Belt , E J T , Bosscha , K , Slooter , G D , Leclercq , W K G , Liem , M S L , Mieog , J S D , Swijnenburg , R J , van Dam , R M , Verhoef , C , Kuhlmann , K , van Duijvendijk , P , Gerhards , M F , Gobardhan , P , van den Boezem , P , Manusama , E R , Grünhagen , D J , Kok , N F M & Torrenga , H 2024 , ' Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases : a nationwide cohort study ' , HPB , vol. 26 , no. 6 , pp. 789-799 .
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1434546349
Document Type :
Electronic Resource