Letter to editor: Does age effect on the short- and long-term outcomes of patients undergoing liver resection for hepatocellular carcinoma?

Author(s):  
Li-Yang Sun ◽  
Yong-Kang Diao ◽  
Chao Li ◽  
Lei Liang ◽  
Cheng-Wu Zhang ◽  
...  
Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 964-972
Author(s):  
Aoxiao He ◽  
Zhihao Huang ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Rongguiyi Zhang ◽  
...  

Abstract Background The feasibility and safety of laparoscopic major hepatectomy (LMH) are still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC). Method Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed. Results Intraoperative blood loss (P = 0.007) was significantly lower in the LMH group. In addition, the LMH group exhibited a lower overall complication rate (P = 0.039) and shorter postoperative hospital stay (P = 0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P = 0.215) and operative cost (P = 0.860). Two laparoscopic cases were converted to open liver resection. In regard to long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P = 0.079) and overall survival (OS) (P = 0.172). Conclusion LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.


2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.


2020 ◽  
Author(s):  
Aoxiao He ◽  
Yong Li ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Wenjun Liao ◽  
...  

Abstract Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.


2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  

Abstract Background The aim of this study was to investigate the prognostic significance of the prognostic nutritional index (PNI) for both short and long term outcomes after liver resection for hepatocellular carcinoma (HCC). Methods 162 (without any previous treatment) of 229 surgically treated HCC patients were retrospectively analyzed. The cut off value of the preoperative PNI was 45.0. Patients were divided into two groups, PNI low (n=76) and high (n=86) group. Results Among some immune parameters such as PNI, neutrophil to lymphocyte ratio (NLR) and aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), PNI had most reliable parameters in terms with prediction of both short and long term outcomes. Preoperative PNI tended to correlate with low skeletal muscle mass (SMM). In short term outcomes, PNI low group were more likely to have postoperative complications. The disease-free survival rate in PNI low group was significantly worse than that in the PNI high group (20.5 vs. 48.7 %, 5 year SR, p=0.03). On multivariate analysis, Low PNI was an independent prognostic factor for disease free survival (HR 1.65, p= 0.04). Conclusions The preoperative PNI was the most significant prognostic factor for evaluating both short and long-term outcomes after liver resection for HCC.


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