Christine March , Maximilian Thormann , Peter Hass , Marilena Georgiades , Maximilian Sensse , Tim Herrmann , Jazan Omari , Maciej Pech , Robert Damm
{"title":"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。","authors":"Christine March , Maximilian Thormann , Peter Hass , Marilena Georgiades , Maximilian Sensse , Tim Herrmann , Jazan Omari , Maciej Pech , Robert Damm","doi":"10.1016/j.brachy.2024.07.001","DOIUrl":null,"url":null,"abstract":"<div><h3>PURPOSE</h3><div>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.</div><div>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.</div></div><div><h3>MATERIALS AND METHODS</h3><div>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.</div></div><div><h3>RESULTS</h3><div>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 (<em>p</em> = 0.003; <em>p</em> = 0.0001).</div><div>Previous partial liver resection, partial bowel resection, and chronic renal failure were independent risk factors for the occurrence of severe complications.</div></div><div><h3>CONCLUSION</h3><div>Severe complications and in-hospital death are rare in the treatment of primary and secondary liver malignancies with percutaneous and angiographic procedures.</div><div>They are a viable alternative or addition to a surgical approach in treating liver lesions.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"23 6","pages":"Pages 743-750"},"PeriodicalIF":1.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mortality and postinterventional complications after ablative treatment of liver malignancies: A cohort study of 4374 patients\",\"authors\":\"Christine March , Maximilian Thormann , Peter Hass , Marilena Georgiades , Maximilian Sensse , Tim Herrmann , Jazan Omari , Maciej Pech , Robert Damm\",\"doi\":\"10.1016/j.brachy.2024.07.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>PURPOSE</h3><div>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.</div><div>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.</div></div><div><h3>MATERIALS AND METHODS</h3><div>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.</div></div><div><h3>RESULTS</h3><div>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 (<em>p</em> = 0.003; <em>p</em> = 0.0001).</div><div>Previous partial liver resection, partial bowel resection, and chronic renal failure were independent risk factors for the occurrence of severe complications.</div></div><div><h3>CONCLUSION</h3><div>Severe complications and in-hospital death are rare in the treatment of primary and secondary liver malignancies with percutaneous and angiographic procedures.</div><div>They are a viable alternative or addition to a surgical approach in treating liver lesions.</div></div>\",\"PeriodicalId\":55334,\"journal\":{\"name\":\"Brachytherapy\",\"volume\":\"23 6\",\"pages\":\"Pages 743-750\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brachytherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1538472124001144\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brachytherapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1538472124001144","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Mortality and postinterventional complications after ablative treatment of liver malignancies: A cohort study of 4374 patients
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.
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.