ArticleAnnals of surgical oncology2026
One-Year Mortality after Hepatectomy: Defining a Novel Quality Metric.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOwing to better technique and perioperative care, 30- and 90-day mortality after hepatectomy has improved. However, little is known about survival in the first year after hepatectomy. PATIENTS AND
methodsPatients (age > 18) who underwent hepatectomy for any indication between 1991-2018 at a single institution were identified. Univariable and multivariable logistic regression were used to assess the relationship between clinical factors and death within 1 year for all patients and for patients who underwent hepatectomy for colorectal liver metastases (CRLM).
resultsThis study included 6191 patients, of which 54% had CRLM. The 1-year survival was 89.9% (95%CI:89.1-90.7%). For patients who survived to 90 days, the probability of survival until 1 year was 92.2% (95%CI:91.9-92.5%). Malignancy had the strongest association with 1-year mortality (11% versus 2%, OR:5.82, 95%CI:2.13-15.88, p < 0.001), followed by major complications (22% versus 7%, OR:2.84, 95%CI:2.31-3.49, p < 0.001) and open approach (11% versus 3%, OR:2.06, 95%CI:1.06-3.98, p = 0.032). In the CRLM subset, the 1-year death rate was 7.6% (95%CI:6.7-8.6%). Major complications (17% versus 5%, OR:2.94, 95%CI:2.10-4.12, p < 0.001), 1-year recurrence (11% versus 5%, OR:2.78, 95%CI:1.97-3.91, p < 0.001), 4+ liver lesions (12% versus 7%, OR:2.12, 95%CI:1.46-3.09, p < 0.001) and hepatitis B/C (20% versus 7%, OR:3.47, 95%CI:1.31-9.16, p = 0.012) were associated with death at 1 year for this subset.
conclusionsThe 1-year mortality after hepatectomy is substantial, with 1 out of 10 patients dying within 1 year of surgery. Unlike the 30- and 90-day mortality, which capture technical or perioperative causes of death, 1-year mortality may serve as a more comprehensive postoperative outcome, by more broadly capturing postsurgical events and disease progression.
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