Mortality and postinterventional complications after ablative treatment of liver malignancies: A cohort study of 4374 patients

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-11-01 DOI:10.1016/j.brachy.2024.07.001

Christine March , Maximilian Thormann , Peter Hass , Marilena Georgiades , Maximilian Sensse , Tim Herrmann , Jazan Omari , Maciej Pech , Robert Damm

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引用次数: 0

Abstract

PURPOSE

Ablative therapies for primary and secondary liver malignancies are increasingly adopted in current guidelines. Nevertheless, surgical resection remains the gold standard in most curative therapy settings.

Extensive studies on mortality and morbidity after ablative treatment of the liver are missing. We investigated complications and mortality after ablative treatment in a large, unselected study cohort.

MATERIALS AND METHODS

Standardized patient and treatment data in 4374 percutaneous and angiographic ablative procedures of the liver from the DRG-based hospital reimbursement system (diagnosis-related groups) of an academic hospital in Germany were retrospectively evaluated. We analyzed descriptive patient data, length of stay (LOS), pre-existing medical conditions, previous gastrointestinal surgeries, severe complications, and occurrence of death.

RESULTS

Treatment of secondary liver malignancies constituted over two-thirds of all procedures (71%, n = 3053). The mean LOS was 4.1 ± 3.5 days. Severe complications were documented in 1.4% and in-house death in 0.2% of cases, significantly more often after treatment with chemoembolization of primary liver malignancies (p = 0.003; p = 0.0001).

Previous partial liver resection, partial bowel resection, and chronic renal failure were independent risk factors for the occurrence of severe complications.

CONCLUSION

Severe complications and in-hospital death are rare in the treatment of primary and secondary liver malignancies with percutaneous and angiographic procedures.

They are a viable alternative or addition to a surgical approach in treating liver lesions.

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肝脏恶性肿瘤消融治疗后的死亡率和介入治疗后并发症：4374 例患者的队列研究。

目的：目前的指南越来越多地采用烧蚀疗法治疗原发性和继发性肝脏恶性肿瘤。然而，手术切除仍是大多数治愈性治疗的金标准。有关肝脏消融治疗后死亡率和发病率的广泛研究尚属空白。我们在一个未经选择的大型研究队列中调查了消融治疗后的并发症和死亡率：我们对德国一家学术医院基于 DRG 的医院报销系统（诊断相关组）中 4374 例经皮和血管造影肝脏消融术的标准化患者和治疗数据进行了回顾性评估。我们分析了患者的描述性数据、住院时间（LOS）、既往病史、既往胃肠道手术、严重并发症和死亡情况：继发性肝脏恶性肿瘤的治疗占所有手术的三分之二以上（71%，n = 3053）。平均住院日为 4.1 ± 3.5 天。有记录显示，1.4%的病例出现严重并发症，0.2%的病例出现内部死亡，原发性肝脏恶性肿瘤化疗栓塞治疗后出现严重并发症的病例明显增多（p = 0.003; p = 0.0001）。曾进行肝部分切除术、肠部分切除术和慢性肾功能衰竭是发生严重并发症的独立危险因素：结论：采用经皮和血管造影术治疗原发性和继发性肝脏恶性肿瘤时，很少出现严重并发症和院内死亡。在治疗肝脏病变时，经皮和血管造影术是一种可行的替代或补充手术方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.