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The complication-overall survival (CompOS) risk tool predicts risk of a severe postoperative complications relative to long-term survival among patients with primary liver cancer. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Endo, Y., Tsilimigras, D. I., Woldesenbet, S., Marques, H. P., Cauchy, F., Weiss, M., Bauer, T. W., Poultsides, G. A., Maithel, S. K., Kitago, M., Alexandrescu, S., Martel, G., Guglielmi, A., Pulitano, C., Gleisner, A., Hugh, T., Aldrighetti, L., Shen, F., Koerkamp, B. G., Endo, I., Pawlik, T. M. 2024; 28 (2): 132-140

Abstract

BACKGROUND: This study aimed to develop a tool based on preoperative factors to predict the risk of perioperative complications based on the Comprehensive Complication Index (CCI) and long-term survival outcomes after liver resection for primary liver cancer.METHODS: Patients with hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC) undergoing curative-intent hepatectomy between 1990 and 2020 were identified using a multi-institutional international database.RESULTS: Among 1411 patients who underwent curative-intent hepatic resection (HCC: 997, 70.7%; ICC: 414, 29.3%), median patient age was 66.0 years (IQR, 57.0-73.0), and most patients were male (n=1001, 70.9%). In the postoperative setting, 699 patients (49.5%) experienced a complication; moreover, 112 patients (7.9%) had major complications. Although most patients had a favorable risk complication-overall survival (CompOS) profile (CCI score>40 risk of <30% and median survival of >5 years: n=778, 55.1%), 553 patients (39.2%) had an intermediate-risk profile, and 80 patients (5.7%) had a very unfavorable risk profile (CCI score>40 risk of =30% and/or median survival of =1.5 years). The areas under the curve of the test and validation cohorts were 0.73 and 0.76, respectively.CONCLUSION: The CompOS risk model accurately stratified patients relative to short- and long-term risks, identifying a subset of patients at a high risk of major complications and poor overall survival.

View details for DOI 10.1016/j.gassur.2023.12.010

View details for PubMedID 38445934