scholarly journals Comparison of liver resection versus TACE for short- and long-term outcomes in patients with intermediate stage hepatocellular carcinoma: a systematic review and meta-analysis

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S260
Author(s):  
I. Labgaa ◽  
D. Clerc ◽  
D. Martin ◽  
N. Halkic ◽  
N. Demartines ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Liver Resection ◽  
Meta Analysis ◽  
Intermediate Stage ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

2018 ◽  
Vol 36 (2) ◽  
pp. 111-123 ◽  
Author(s):  
Tim van Tuil ◽  
Ali A. Dhaif ◽  
Wouter W. te Riele ◽  
Bert van Ramshorst ◽  
Hjalmar C. van Santvoort
Keyword(s):  
Systematic Review ◽  
Liver Resection ◽  
Elderly Patients ◽  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Colorectal Metastases ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Short And Long Term

Background: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. Methods: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. Results: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included. Postoperative morbidity was similar in patients aged >70 years (27 vs. 30%; p = 0.35) but higher in patients aged >75 years (21 vs. 32%; p = 0.001). Postoperative mortality was higher in both patients aged >70 years (2 vs. 4%; p = 0.01) and in patients aged >75 years (1 vs. 6%; p = 0.02). Mean 5-year overall survival was lower in patients aged >70 years (40 vs. 32%; p < 0.001) but equal in patients aged >75 years (42 vs. 32%; p = 0.06). Conclusion: Although postoperative morbidity and mortality were increased with higher age, liver resection for CRLM seems justified in selected elderly patients.

scholarly journals Shorter survival after liver pedicle clamping in patients undergoing liver resection for hepatocellular carcinoma revealed by a systematic review and meta-analysis

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
C -H Wassmer ◽  
B Moeckli ◽  
T Berney ◽  
C Toso ◽  
L Orci
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Liver Resection ◽  
Tumor Recurrence ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Remnant Liver ◽  
Long Term Outcomes ◽  
The Impact

Abstract Objective Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma (HCC) having a high rate of recurrence, evidences demonstrating an eventual association with pedicle clamping is strongly needed. Methods We did a systematic review of the literature until April 2020, looking at studies reporting the impact of liver pedicle clamping on long-term outcomes in patients undergoing liver resection for HCC. Primary and secondary outcomes were overall survival (OS) and disease-free survival, respectively. Results Results were obtained by random-effect meta-analysis and expressed as standardized mean difference (SMD). Eleven studies were included, accounting for 8087 patients. Results of seven studies were pooled in a meta-analysis. Findings indicated that, as compared to control patients who did not receive liver pedicle clamping, those who did had a significantly shorter OS (SMD = -0.172, 95%CI: -0.298 to -0.047, p = 0.007, I2=76.8%) and higher tumor recurrence rates (odds ratio 1.36 1.01 to 1.83. p = 0.044, I2=50.7%). Conclusion This meta-analysis suggests that liver pedicle clamping may have a deleterious impact on long-term outcomes. An individual patient-data meta-analysis of randomized trials evaluating liver pedicle clamping is urgently needed.

scholarly journals Shorter Survival after Liver Pedicle Clamping in Patients Undergoing Liver Resection for Hepatocellular Carcinoma Revealed by a Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 637
Author(s):  
Charles-Henri Wassmer ◽  
Beat Moeckli ◽  
Thierry Berney ◽  
Christian Toso ◽  
Lorenzo A. Orci
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Liver Resection ◽  
Tumor Recurrence ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Remnant Liver ◽  
Long Term Outcomes ◽  
The Impact

Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma (HCC) having a high rate of recurrence, evidences demonstrating an eventual association with pedicle clamping is strongly needed. We did a systematic review of the literature until April 2020, looking at studies reporting the impact of liver pedicle clamping on long-term outcomes in patients undergoing liver resection for HCC. Primary and secondary outcomes were overall survival (OS) and disease-free survival, respectively. Results were obtained by random-effect meta-analysis and expressed as standardized mean difference (SMD). Eleven studies were included, accounting for 8087 patients. Results of seven studies were pooled in a meta-analysis. Findings indicated that, as compared to control patients who did not receive liver pedicle clamping, those who did had a significantly shorter OS (SMD = −0.172, 95%CI: −0.298 to −0.047, p = 0.007, I2 = 76.8%) and higher tumor recurrence rates (odds ratio 1.36 1.01 to 1.83. p = 0.044, I2 = 50.7%). This meta-analysis suggests that liver pedicle clamping may have a deleterious impact on long-term outcomes. An individual patient-data meta-analysis of randomized trials evaluating liver pedicle clamping is urgently needed.

Does Conversion to Open of Laparoscopically Attempted Rectal Cancer Cases Affect Short- and Long-Term Outcomes? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 28 (2) ◽  
pp. 117-126 ◽  
Author(s):  
Nikolaos Gouvas ◽  
Panagiotis A. Georgiou ◽  
Christos Agalianos ◽  
Georgios Tzovaras ◽  
Paris Tekkis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients

2018 ◽  
Vol 33 (5) ◽  
pp. 1491-1507 ◽  
Author(s):  
Jan Witowski ◽  
Mateusz Rubinkiewicz ◽  
Magdalena Mizera ◽  
Michał Wysocki ◽  
Natalia Gajewska ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Surgery ◽  
Meta Analysis ◽  
Long Term Outcomes ◽  
Short And Long Term

723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Letícia Nogueira Datrino ◽  
Clara Lucato Santos ◽  
Guilherme Tavares ◽  
Luca Schiliró Tristão ◽  
Maria Carolina Andrade Serafim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Meta Analysis ◽  
Operation Time ◽  
Extended Lymphadenectomy ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

Abstract   Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (&gt;18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

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