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Short- and Long-Term Outcomes of Liver Resection for Intrahepatic Cholangiocarcinoma Associated with the Metabolic Syndrome

  • Christian Hobeika
  • François Cauchy
  • Nicolas Poté
  • Pierre-Emmanuel Rautou
  • François Durand
  • Olivier Farges
  • Safi Dokmak
  • Valérie Vilgrain
  • Maxime Ronot
  • Valérie Paradis
  • Olivier SoubraneEmail author
Article
  • 49 Downloads

Abstract

Background

While the metabolic syndrome (MS) is being recognized as an important risk factor for intrahepatic cholangiocarcinoma (ICC), the outcomes of liver resection in this context remain poorly described. This study aims to report the short- and long-term results of hepatectomy for patients with MS as risk factor for the development of ICC (MS+).

Methods

All patients undergoing hepatectomy for ICC between 2000 and 2016 at a single center were retrospectively analyzed. The perioperative outcomes of MS+ and ICC patients without MS (MS−) were compared.

Results

Among 115 resected ICC patients, 40 (34.8%) were MS+ and 75 (65.2%) were MS−. MS+ exhibited an increased Charlson comorbidity index (5 ± 2 vs. 2 ± 2, p < 0.001) than MS− patients. While operative characteristics did not differ significantly between the 2 groups, MS+ experienced higher rate of major complications (62.5 vs. 29.3%, p = 0.001). On multivariate analysis, MS+ was an independent risk factor of major complication (HR 2.86, 95% CI 1.07–7.60, p = 0.036) and major cardiorespiratory complication (HR 4.35, 95% CI 1.50–12.62, p = 0.007). Pathological analysis revealed that MS+ displayed higher rates of non-alcoholic fatty liver disease (60.0 vs. 31.1%, p = 0.003) and non-alcoholic steatohepatitis (25 vs. 5.4%, p = 0.005). MS+ was independently associated with decreased risk of recurrence (HR 0.47, 95% CI 0.26–0.85, p = 0.001).

Conclusions

MS+ accounts for 35% of resected ICC patients. The existence of significant cardiovascular comorbidities increases postoperative morbidity and requires specific management.

Notes

Compliance with ethical standards

Conflict of interest

None of the authors have any conflict of interest of any kind.

Supplementary material

268_2019_4996_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 31 kb)
268_2019_4996_MOESM2_ESM.TIF
Supplementary material 2 (TIFF 63 kb)
268_2019_4996_MOESM3_ESM.TIF
Supplementary material 3 (TIFF 59 kb)

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Christian Hobeika
    • 1
    • 2
    • 3
  • François Cauchy
    • 1
    • 2
    • 3
  • Nicolas Poté
    • 2
    • 3
    • 4
  • Pierre-Emmanuel Rautou
    • 2
    • 3
    • 5
  • François Durand
    • 2
    • 3
    • 5
  • Olivier Farges
    • 1
    • 2
    • 3
  • Safi Dokmak
    • 1
    • 2
    • 3
  • Valérie Vilgrain
    • 2
    • 3
    • 6
  • Maxime Ronot
    • 2
    • 3
    • 6
  • Valérie Paradis
    • 2
    • 3
    • 4
  • Olivier Soubrane
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of HPB Surgery and Liver TransplantationBeaujon HospitalClichyFrance
  2. 2.Assistance Publique Hôpitaux de ParisParisFrance
  3. 3.Université Paris VII Paris-DiderotParisFrance
  4. 4.Department of PathologyBeaujon HospitalClichyFrance
  5. 5.Department of HepatologyBeaujon HospitalClichyFrance
  6. 6.Department of RadiologyBeaujon HospitalClichyFrance

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