scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

2020 ◽  
Author(s):  
Aoxiao He ◽  
Yong Li ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Wenjun Liao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

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.

scholarly journals Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 964-972
Author(s):  
Aoxiao He ◽  
Zhihao Huang ◽  
Jiakun Wang ◽  
Qian Feng ◽  
Rongguiyi Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Major Hepatectomy ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Laparoscopic Major Hepatectomy

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.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

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.

scholarly journals Preoperative prognostic nutritional index predicts both short and long-term outcomes after liver resection for hepatocellular carcinoma.

2019 ◽  
Author(s):  
Yu Saito ◽  
Satoru Imura ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Shinichiro Yamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Nutritional Index ◽  
Short And Long Term ◽  
Disease Free

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.

scholarly journals Age Is No Longer a Limit: Two Cases of Hepatectomy in Patients Over 90 Years Old

2015 ◽  
Vol 9 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Shugo Uwatoko ◽  
Kentaroh Yamamoto ◽  
Takamitsu Sasaki ◽  
Daisuke Fukumori ◽  
Hirotsune Igimi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Major Hepatectomy ◽  
Long Term Outcomes ◽  
Younger Patients ◽  
The World ◽  
Short And Long Term

Hepatocellular carcinoma (HCC) is a common malignant tumor with poor prognosis. The age of patients affected by HCC is considered to be increasing, and several studies have reported significantly higher rates of morbidity and mortality after hepatectomy for HCC in elderly patients. However, other studies have reported that the short- and long-term outcomes of surgery for HCC in elderly patients are similar to those in younger patients. Whether the indications for hepatic resection in elderly patients resemble those in younger patients has thus been questioned. We describe two cases of patients over 90 years old who underwent major hepatectomy for HCC, representing the oldest patients in the world to have done so.

Reappraisal of the risks and benefits of major liver resection in patients with initially unresectable colorectal liver metastases.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3609-3609
Author(s):  
Francois Cauchy ◽  
Beatrice Aussilhou ◽  
Safi Dokmak ◽  
David Fuks ◽  
Olivier Farges ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Resection ◽  
Adjuvant Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Major Hepatectomy ◽  
Major Liver Resection ◽  
Long Term Outcomes ◽  
Unresectable Colorectal Liver Metastases ◽  
Short And Long Term

3609 Background: Improvements in both surgical technique and efficacy of chemotherapy have increased the rate of resection for patients with initially unresectable colorectal liver metastases (IU-CRLM). We aimed to evaluate the short and long-term outcomes of major hepatectomy for such patients. Methods: From 2000 to 2011, 257 patients underwent major hepatectomy for CRLM. Seventy-eight (30%) of these patients were considered IU and required portal vein occlusion and/or ≥12 cycles or change in induction chemotherapy regimen to achieve resectability. Results: IU patients had respectively more lesions (5.6 vs.3.6, p=0.001), more frequently bilobar (70% vs.50% p=0.008) and synchronous (83.3% vs.70%, p=0.027) than initially resectable (IR) patients. Post-operative mortality (12.8% vs.1.7%, p=0.001) and major complications (46.2% vs.22.3%, p=0.0001) were higher in IU patients. An associated metabolic syndrome (HR 5.2, CI 1.2-21.9, p=0.025), high grade sinusoidal lesions (HR 2.4, CI 1.1-5.8, p=0.044) and the need for vascular reconstruction (HR 6.3, CI 1.2-34.4, p=0.032) were significant risk factors for major morbidity in IU patients. Significantly fewer IU patients received adjuvant chemotherapy in case of major postoperative complications compared to IR patients (47% vs. 83%, p=0.001). Overall 5-year survival was significantly lower in IU than in IR patients (26% vs.55%, p=0.032) and all IU patients had tumor recurrence within 3 years. The absence of adjuvant chemotherapy and tumor size ≥5 cm were the only factors associated with poor survival in multivariate analysis for IU patients. Conclusions: IU-CRLM patients requiring major liver resection displayed higher morbidity and mortality rates than IR ones, therefore compromising both short and long-term outcomes. Multimodal strategy should be reassessed in the presence of metabolic syndrome, sinusoidal lesions or major vascular involvement.

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