Publication: Liver Transplantation as a New Standard of Care in Patients With
Perihilar Cholangiocarcinoma? Results From an International
Benchmark Study
| dc.contributor.author | Breuer, Eva | |
| dc.contributor.author | Mueller, Matteo | |
| dc.contributor.author | Doyle, Majella B. | |
| dc.contributor.author | Yang, Liu | |
| dc.contributor.author | Darwish Murad, Sarwa | |
| dc.contributor.author | Ramirez, Pablo | |
| dc.contributor.author | Clavien, Pierre-Alain | |
| dc.contributor.department | Cirugía, Pediatría y Obstetricia y Ginecología | |
| dc.date.accessioned | 2025-01-30T15:45:45Z | |
| dc.date.available | 2025-01-30T15:45:45Z | |
| dc.date.created | 2022-11 | |
| dc.description | © 2022 The Authors. This document is the published version of a published work that appeared in final form Annals of Surgery This document is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0 . To access the final edited and published work see: https://www.doi.org/10.1097/SLA.0000000000005641 | |
| dc.description.abstract | 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 <3 cm, negative lymph nodes, and with the absence of relevant comorbidities. Benchmark cutoff values were derived from the 75th to 25th percentiles of the median values of all benchmark centers. 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. | es |
| dc.format | application/pdf | es |
| dc.format.extent | 8 | es |
| dc.identifier.citation | Annals of Surgery Vol. 276, nº 5, November 2022 | |
| dc.identifier.doi | https://www.doi.org/10.1097/SLA.0000000000005641 | |
| dc.identifier.issn | Print.: 0003-4932 | |
| dc.identifier.issn | Electronic.: 1528-1140 | |
| dc.identifier.uri | http://hdl.handle.net/10201/149784 | |
| dc.language | eng | es |
| dc.publisher | Lippincott, Williams & Wilkins | |
| dc.relation | Sin financiación externa a la Universidad. | es |
| dc.relation.publisherversion | https://journals.lww.com/annalsofsurgery/fulltext/2022/11000/liver_transplantation_as_a_new_standard_of_care_in.15.aspx | |
| dc.rights | info:eu-repo/semantics/openAccess | es |
| dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
| dc.subject | Benchmarks | es |
| dc.subject | CCI® | |
| dc.subject | Complications | |
| dc.subject | Liver transplantation | |
| dc.subject | Mayo-protocol | |
| dc.subject | Outcomes | |
| dc.subject | Perihilar cholangiocarcinoma | |
| dc.subject.other | CDU::6 - Ciencias aplicadas::61 - Medicina::617 - Cirugía. Ortopedia. Oftalmología | es |
| dc.title | Liver Transplantation as a New Standard of Care in Patients With Perihilar Cholangiocarcinoma? Results From an International Benchmark Study | es |
| dc.type | info:eu-repo/semantics/article | es |
| dspace.entity.type | Publication | es |
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