Benchmarks and geographic differences in gallbladder cancer surgery: an international multicenter study
Autor
Vega, Eduardo A.
Newhook, Timothy E.
Mellado, Sebastian
Ruzzenente, Andrea
Okuno, Masayuki
De Bellis, Mario
Panettieri, Elena
Usman Ahmad, M.
Merlo, Ignacio
Rojas, Jesus
De Rose, Agostino M.
Nishino, Hiroto
Sinnamon, Andrew J.
Donadon, Matteo
Hauger, Marit S.
Guevara, Oscar A.
Munoz, César
Denbo, Jason W.
Shin Chun, Yun
Tran Cao, Hop S.
Sanchez Claria, Rodrigo
Tzeng, Ching-Wei D.
De Aretxabala, Xabier
Vivanco, Marcelo
Brudvik, Kristoffer W.
Seo, Satoru
Pekolj, Juan
Poultsides, George A.
Torzilli, Guido
Giuliante, Felice
Anaya, Daniel A.
Guglielmi, Alfredo
Vinuela, Eduardo
Vauthey, Jean-Nicolas
Fecha
2023Resumen
Background
High-quality surgery plays a central role in the delivery of excellent oncologic care. Benchmark values indicate the best achievable results. We aimed to define benchmark values for gallbladder cancer (GBC) surgery across an international population.
Patients and Methods
This study included consecutive patients with GBC who underwent curative-intent surgery during 2000–2021 at 13 centers, across seven countries and four continents. Patients operated on at high-volume centers without the need for vascular and/or bile duct reconstruction and without significant comorbidities were chosen as the benchmark group.
Results
Of 906 patients who underwent curative-intent GBC surgery during the study period, 245 (27%) were included in the benchmark group. These were predominantly women (n = 174, 71%) and had a median age of 64 years (interquartile range 57–70 years). In the benchmark group, 50 patients (20%) experienced complications within 90 days after surgery, with 20 patients (8%) developing major complications (Clavien–Dindo grade ≥ IIIa). Median length of postoperative hospital stay was 6 days (interquartile range 4–8 days). Benchmark values included ≥ 4 lymph nodes retrieved, estimated intraoperative blood loss ≤ 350 mL, perioperative blood transfusion rate ≤ 13%, operative time ≤ 332 min, length of hospital stay ≤ 8 days, R1 margin rate ≤ 7%, complication rate ≤ 22%, and rate of grade ≥ IIIa complications ≤ 11%.
Conclusions
Surgery for GBC remains associated with significant morbidity. The availability of benchmark values may facilitate comparisons in future analyses among GBC patients, GBC surgical approaches, and centers performing GBC surgery.
Fuente
Annals of Surgical Oncology, 30(8), 4904-4911Link de Acceso
Click aquí para ver el documentoIdentificador DOI
doi.org/10.1245/s10434-023-13531-2Colecciones
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