Evidence map›Paper›PMID 39921532›Full record

ArticleBJS open2024

Association of preoperative frailty with short- and long-term outcomes after hepatic resection for elderly patients with hepatocellular carcinoma: multicentre analysis.

Yong-Kang Diao, Dan Li, Han Wu, Yi-Fan Yang, Nan-Ya Wang, Wei-Min Gu, Ting-Hao Chen, Jie Li, Hong Wang, Ya-Hao Zhou and 9 more

Abstract readMulticenter Study
In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Yong-Kang DiaoDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Dan LiDepartment of Hepatobiliary and Pancreatic Surgery, General Surgery Centre, First Hospital of Jilin University, Changchun, Jilin, China.
Han WuDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0002-9829-3600
Yi-Fan YangDepartment of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Nan-Ya WangPhase I Clinical Trial Unit, Department of Clinical Research, First Hospital of Jilin University, Changchun, Jilin, China.
Wei-Min GuFirst Department of General Surgery, Fourth Hospital of Harbin, Harbin, Heilongjiang, China.
Ting-Hao ChenDepartment of General Surgery, Ziyang First People's Hospital, Ziyang, Sichuan, China.
Jie LiDepartment of Hepatobiliary Surgery, Fuyang People's Hospital, Fuyang, Anhui, China.
Hong WangDepartment of General Surgery, Liuyang People's Hospital, Liuyang, Hunan, China.
Ya-Hao ZhouDepartment of Hepatobiliary Surgery, Pu'er People's Hospital, Pu'er, Yunnan, China.
Ying-Jian LiangDepartment of Hepatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Xian-Ming WangDepartment of General Surgery, First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.
Kong-Ying LinDepartment of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fuzhou, Fujian, China.
Li-Hui GuDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Jia-Hao XuDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Timothy M PawlikDepartment of Surgery, Ohio State University, Wexner Medical Centre, Columbus, Ohio, USA.ORCID 0000-0002-7994-9870
Wan-Yee LauDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Feng ShenDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Tian YangDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.ORCID 0000-0003-0575-0698

Funding

Dawn Project Foundation of Shanghai 21SG36National Natural Science Foundation of China 82425049Shanghai Health and Hygiene Discipline Leader Project 2022XD001Shanghai Outstanding Academic Leader Programme 23XD1424900
6 · The paper itself

Abstract

backgroundThe growing demand for surgical resection in elderly patients with hepatocellular carcinoma highlights the need to understand the impact of preoperative frailty on surgical outcomes. The aim of this multicentre cohort study was to investigate the association between frailty and short- and long-term outcomes after hepatic resection among elderly patients with hepatocellular carcinoma.

methodsA multicentre analysis was conducted on elderly patients with hepatocellular carcinoma (aged greater than or equal to 70 years) who underwent curative-intent resection at ten Chinese hospitals from 2012 to 2021. Frailty was assessed using the Clinical Frailty Scale (with frailty defined as a Clinical Frailty Scale score greater than or equal to 5). The primary outcomes were overall survival and recurrence-free survival; secondary outcomes encompassed postoperative 30-day morbidity and mortality, and 90-day mortality. The outcomes between patients with and without preoperative frailty were compared.

resultsOf the 488 elderly patients, 148 (30.3%) were considered frail. Frail patients experienced significantly higher 30-day morbidity (68.9% (102 of 148) versus 43.2% (147 of 340)), 30-day mortality (4.1% (6 of 148) versus 0.6% (2 of 340)), and 90-day mortality (6.1% (9 of 148) versus 0.9% (3 of 340)) compared with non-frail patients (all P < 0.010). During a median follow-up of 37.7 (interquartile range 20.4-57.8) months, frail patients demonstrated significantly worse median overall survival (41.6 (95% c.i. 32.0 to 51.2) versus 69.7 (95% c.i. 55.6 to 83.8) months) and recurrence-free survival (27.6 (95% c.i. 23.1 to 32.1) versus 42.7 (95% c.i. 34.6 to 50.8) months) compared with non-frail patients (both P < 0.010). Multivariable Cox regression analysis revealed frailty as an independent risk factor for decreased overall survival (HR 1.61; P = 0.001) and decreased recurrence-free survival (HR 1.32; P = 0.028).

conclusionFrailty is significantly associated with adverse short-term and long-term outcomes after resection in elderly patients with hepatocellular carcinoma. The findings suggest that frailty assessment should be incorporated into perioperative and postoperative evaluation for elderly patients undergoing hepatocellular carcinoma resection.

Indexed as

Carcinoma, HepatocellularFrail ElderlyFrailtyHepatectomyLiver NeoplasmsPostoperative ComplicationsAgedAged, 80 and overChinaFemaleHumansMaleRetrospective StudiesTreatment Outcome

Identifiers

PMID39921532
PMCPMC11806262

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.