
We sought to define textbook outcome in liver surgery (TOLS) for intrahepatic cholangiocarcinoma (ICC) by considering the implications of perioperative outcomes on overall survival (OS).Using a multi-institutional database, TOLS for ICC was defined by employing novel machine learning (ML) models to identify perioperative factors most strongly predictive of OS ≥ 12 months. Subsequently, clinicopathologic factors associated with achieving TOLS were investigated.A total of 1556 patients with ICC were included. The ML classification models demonstrated that the absence of post-hepatectomy liver failure, intraoperative blood loss 2, lymph node metastasis, receipt of neoadjuvant therapy, advanced T status, poor histological grade and microvascular invasion were independently associated with lower odds of achieving TOLS (all p-values<0.05). Overall, 60.2 % (n = 936) of the patients achieved TOLS, demonstrating markedly improved OS and recurrence-free survival (RFS) than individuals who did not (both p < 0.05).A standardized definition of TOLS for ICC was established that may be used to evaluate hospital performance at the patient level and help optimize surgical outcomes for patients with ICC.
Male, Time Factors, Databases, Factual, Middle Aged, textbook outcome laparoscopic liver surgery intrahepatic cholangiocarcinoma, Cholangiocarcinoma, Machine Learning, Treatment Outcome, Bile Duct Neoplasms, Risk Factors, Humans, Hepatectomy, Female, Aged, Retrospective Studies
Male, Time Factors, Databases, Factual, Middle Aged, textbook outcome laparoscopic liver surgery intrahepatic cholangiocarcinoma, Cholangiocarcinoma, Machine Learning, Treatment Outcome, Bile Duct Neoplasms, Risk Factors, Humans, Hepatectomy, Female, Aged, Retrospective Studies
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