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Textbook outcome in liver surgery for intrahepatic cholangiocarcinoma: defining predictors of an optimal postoperative course using machine learning

defining predictors of an optimal postoperative course using machine learning
Authors: Abdullah Altaf; Mujtaba Khalil; Miho Akabane; Zayed Rashid; Jun Kawashima; Shahzaib Zindani; Andrea Ruzzenente; +15 Authors

Textbook outcome in liver surgery for intrahepatic cholangiocarcinoma: defining predictors of an optimal postoperative course using machine learning

Abstract

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.

Countries
Italy, Netherlands
Keywords

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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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
hybrid
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