Preoperative multivariable prognostic models for prediction of survival and major complications following surgical resection of @entity1358 with suprahepatic caval @entity5 XXXX .

@entity1 @entity5 @entity5906 @entity1358 @entity3 @entity715 @entity1349
OBJECTIVE: Surgical resection for @entity1358 ( @entity1358 ) with suprahepatic inferior vena cava @entity5 @entity715 is associated with significant morbidity, yet there are currently no tools for preoperative prognostic evaluation. Our goal was to develop a preoperative multivariable model for prediction of survival and risk of major complications in @entity1 with suprahepatic thrombi. METHODS: We identified @entity1 who underwent surgery for @entity1358 with @entity5 @entity715 extension from 2000 to 2013 at 4 tertiary centers. A Cox proportional hazard model was used for analysis of @entity1349 ( @entity1349 ) and logistic regression was used for major complications within 90 days of surgery (Clavien>= 3A). Nomograms were internally calibrated by bootstrap resampling method. RESULTS: A total of 49 @entity1 with level III @entity715 and 83 @entity1 with level IV @entity715 were identified. During median follow-up of 24.5 months, 80 @entity1 (60.6%) died and 46 @entity1 (34.8%) experienced major complication. Independent prognostic factors for @entity1349 included distant @entity3 at presentation (hazard ratio = 2.52, P = 0.002) and Eastern Cooperative Oncology Group (ECOG) performance status (hazard ratio = 1.84, P<0.0001). Variables associated with increased risk of major complications on univariate analysis included preoperative systemic symptoms, level IV @entity715 , and elevated preoperative alkaline phosphatase and @entity5906 transaminase levels; however, only systemic symptoms (odds ratio = 8.45, P<0.0001) was an independent prognostic factor. Preoperative nomograms achieved a concordance index of 0.72 for @entity1349 and 0.83 for major complications. CONCLUSIONS: We have developed and internally validated multivariable preoperative models for the prediction of survival and major complications in @entity1 with @entity1358 who have a suprahepatic inferior vena cava @entity715 . If externally validated, these tools may aid in @entity1 selection for surgical intervention.
