ArticleJournal of surgical oncology2017
Borderline operability in hepatectomy patients is associated with higher rates of failure to rescue after severe complications.
Article in Journal of surgical oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Risk Factors and Strategies for Failure to Rescue Following Hepatectomy: A Review.Journal of hepato-biliary-pancreatic sciences · 2025Review
- MELD-Na Score as a Predictor of Postoperative Complications in Ventral Skull Base Surgery.Journal of neurological surgery. Part B, Skull base · 2023Article
- Enhanced Recovery After Surgery: Hepatobiliary.The Surgical clinics of North America · 2018Review
- Update on Liver Failure Following Hepatic Resection: Strategies for Prediction and Avoidance of Post-operative Liver Insufficiency.Journal of clinical and translational hepatology · 2018Review
- What Is "Enhanced Recovery," and How Can I Do It?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Predictors of Reoperation and Failure to Rescue in Bariatric Surgery.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND/
objectiveTo understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis.
methodsAll elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database. Predictors of 30-day morbidity/mortality in BL patients were analyzed.
resultsA 3,574/15,920 (22.4%) patients met BL criteria. Despite non-BL and BL patients undergoing similar magnitude hepatectomies (P > 0.4), BL patients had higher severe complication (SC, 23.3% vs. 15.3%) and mortality rates (3.7% vs. 1.2%, P < 0.001). BL patients with any SC experienced a 14.1% mortality rate (vs. 7.3%, non-BL, P < 0.001). Independent risk factors for SC in BL patients included American Society of Anesthesiologists (ASA) score >3 (odds ratio, OR - 1.29), smoking (OR - 1.41), albumin <3.5 g/dl (OR - 1.36), bilirubin >1 (OR - 2.21), operative time >240 min (OR - 1.58), additional colorectal procedure (OR - 1.78), and concurrent procedure (OR - 1.73, all P < 0.05). Independent predictors of mortality included disseminated cancer (OR - 0.44), albumin <3.5 g/dl (OR - 1.94), thrombocytopenia (OR - 1.95), and extended/right hepatectomy (OR - 2.81, all P < 0.01).
conclusionsHepatectomy patients meeting BL criteria have an overall post-hepatectomy mortality rate that is triple that of non-BL patients. With less clinical reserve, BL patients who suffer SC are at greater risk of post-hepatectomy death. J. Surg. Oncol. 2017;115:337-343. © 2016 Wiley Periodicals, Inc.
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