scholarly journals Laparoscopically Resected Solitary Metastasis of Hepatocellular Carcinoma to the Round Ligament

2016 ◽  
Vol 101 (7-8) ◽  
pp. 334-337 ◽  
Author(s):  
SiYuan Yao ◽  
Atsushi Ikeda ◽  
Teppei Murakami ◽  
Tatsuo Okumoto ◽  
Eiji Tanaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Disease Free Survival ◽  
Laparoscopic Approach ◽  
Distant Metastases ◽  
Round Ligament ◽  
Perioperative Outcomes ◽  
Free Survival ◽  
Rare Site ◽  
Lung Lymph

Hepatocellular carcinoma (HCC) is known to metastasize to the lung, lymph node, and musculoskeletal regions; however, to our knowledge, metastasis to the round ligament of the liver has never been reported. In addition, because the conventional approach for surgical resection of intra-abdominal metastasis is open surgery, the laparoscopic approach has been rarely performed. This report presents the case of a 72-year-old Asian man who developed a tumor in the round ligament, a rare site for distant metastases, 2 years after complete resection of an HCC. As the tumor was solitary and noninvasive, laparoscopic resection was planned and safely performed. He has now been free of recurrence for more than 3 years. Good perioperative outcomes and a long-term disease-free survival were thus achieved with minimally invasive surgery. In addition to being the first report of this rare recurrence site, this is also the first reported case of resection of an extrahepatic metastasis by laparoscopic surgery alone. This report may encourage surgeons to select a laparoscopic approach when managing intra-abdominal metastases from an HCC.

scholarly journals Elderly Hepatocellular Carcinoma Patients: Open or Laparoscopic Approach?

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2281
Author(s):  
Jong Man Kim ◽  
Sangjin Kim ◽  
Jinsoo Rhu ◽  
Gyu-Seong Choi ◽  
Choon Hyuck David Kwon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Elderly Patients ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Transfusion Rate ◽  
Treatment Naïve

It remains unclear whether the short-term benefits and long-term outcomes of laparoscopic liver resection (LLR) accrue to elderly patients with medical comorbidities. The aim of the present study was to compare the outcomes between LLR and open liver resection (OLR) in elderly patients (≥65 years) with solitary, treatment-naïve solitary hepatocellular carcinoma (HCC). From January 2013 to August 2017, 256 elderly patients with solitary treatment-naive HCC underwent liver resection. All patients were Child–Pugh class A and older than 65 years. The OLR and LLR groups contained 160 and 96 patients, respectively. The median tumor size in the OLR group was significantly larger than that in the LLR group (3.9 vs. 2.6 cm), but the tumor size did not differ between the two groups after matching. The median operation time, blood loss, transfusion rate, and postoperative complications in the OLR group did not differ from those in the LLR group, but the operation time in the LLR group was longer than that in the OLR group after matching. The median hospitalization in the LLR group was significantly shorter than that in the OLR group. Disease-free survival (DFS) in the LLR group was better than that in the OLR group before and after matching, but the difference was not significant. Patient survival (PS) in the LLR group was similar to that in the OLR group. LLR is feasible and safe for elderly patients with solitary, treatment-naïve HCC. The short- and long-term benefits of LLR are evident in geriatric oncological liver surgery patients.

Validation of the Conventional Resection Criteria in Patients with Hepatocellular Carcinoma in Terms of the Incidence of Posthepatectomy Liver Failure and Long-Term Prognosis

2015 ◽  
Vol 32 (5) ◽  
pp. 344-351 ◽  
Author(s):  
Kohta Iguchi ◽  
Etsuro Hatano ◽  
Kenya Yamanaka ◽  
Shiro Tanaka ◽  
Kojiro Taura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Failure ◽  
Disease Free Survival ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Free Survival ◽  
Posthepatectomy Liver Failure ◽  
Long Term Prognosis ◽  
Patient Prognosis

Background/Aims: Resection criteria in hepatocellular carcinoma (HCC) should be established based on the risk of posthepatectomy liver failure (PHLF) and the survival benefit from hepatectomy. This study aimed at verifying the validity of the conventional criteria regarding the incidence of PHLF and the long-term prognosis of HCC patients. Methods: A retrospective study was performed on 265 patients who underwent major hepatectomy. Makuuchi's criteria and the future liver remnant plasma clearance rate of indocyanine green (ICGK-rem) ≥0.05 criterion were evaluated. Results: A total of 107 and 158 patients were within and beyond Makuuchi's criteria, respectively. Makuuchi's criteria were associated with the incidence of PHLF (p = 0.03) but not with its severity (p = 0.12). No differences in disease-free survival (DFS) or overall survival (OS) were observed between the groups (p = 0.75 and p = 0.94, respectively). Using the ICGK-rem ≥0.05 criterion, 223 and 42 patients were within and beyond the criterion, respectively. ICGK-rem was correlated with both the incidence of PHLF (p = 0.002) and its severity (p = 0.03). No differences in DFS or OS were observed between the groups (p = 0.75 and p = 0.29, respectively). Conclusions: Strict criteria are likely to preclude some patients from obtaining the greater survival benefits of hepatectomy. New criteria that consider patient prognosis are needed.

Surgical Outcomes in Hepatitis C Virus-Related Hepatocellular Carcinoma: Special Reference to Sustained Virological Responses to Interferon Therapy

2017 ◽  
Vol 83 (11) ◽  
pp. 1246-1255 ◽  
Author(s):  
Shogo Tanaka ◽  
Akihiro Tamori ◽  
Shigekazu Takemura ◽  
Genya Hamano ◽  
Tokuji Ito ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Hepatic Resection ◽  
Surgical Outcomes ◽  
Interferon Therapy ◽  
Disease Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Disease Free

Long-term surgical outcomes after hepatic resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) to interferon (IFN) therapy remain inconclusive. Clinical records of 277 patients who underwent hepatic resection for HCV-related early stage HCC (met the Milan criteria) between 1993 and 2012 were retrospectively reviewed. Thirty-seven patients achieved the SVR during HCC detection (pre-SVR group), whereas 23 achieved SVR using adjuvant interferon therapy after hepatic resection (post-SVR group). The control group included remaining 217 patients. We investigated the SVR effects on surgical outcomes. Disease-free survival (DFS) rates at 5/10/15 years after hepatic resection were significantly greater in the pre and post-SVR groups than in the control group (46/30/30per cent and 61/36/27 per cent vs 23/7/7 per cent, respectively; P < 0.001). Overall survival (OS) rates at 10/15 years after hepatic resection were better in the pre- and post-SVR groups than in the control group (68/68 percent and 78/78 per cent vs 13/11 per cent, respectively; P < 0.001). On multivariate analysis, pre- and post-SVR were independent factors for no recurrence (pre-SVR: hazard ratio (HR), 0.48, P = 0.002; post-SVR: HR, 0.41, P = 0.001) and improved survival (pre-SVR: HR, 0.36, P = 0.002; post-SVR: HR, 0.122, P < 0.001). Achievement of SVR in patients with HCV-related HCC was associated with long-term disease-free survival and OS after hepatic resection.

Evolving Role of Hepatic Resection for Metastatic Urologic Malignancies

2017 ◽  
Vol 83 (6) ◽  
pp. 628-632 ◽  
Author(s):  
John B. Hamner ◽  
Mustafa Raoof ◽  
Sinziana Dumitra ◽  
Hans F. Schoellhammer ◽  
Carly Crowder ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
R0 Resection ◽  
Term Survival ◽  
Free Survival ◽  
Urologic Malignancies ◽  
Disease Free

Liver resection for noncolorectal, nonneuroendocrine metastases remains controversial. Here, we evaluate a single institutional experience with hepatic resection for metastatic urologic malignancies. A single-institution review of patients who underwent hepatic resection for metastatic urologic tumors between the years of 2000 and 2013 was performed. Patient charts were analyzed for pathologic data and perioperative outcomes including short- and long-term morbidity, mortality, and overall and disease-free survival. Eleven patients were identified who underwent hepatic resection for metastatic urologic malignancy. The mean age was 63.5 years. All patients had an R0 resection. There were three major complications. Mean length of stay was 6.5 days and there was no 90-day mortality. Three patients have died of recurrent disease at an average of 11.2 months from resection to death. The remaining patients are still alive during a mean follow-up of 31.5 months. Five-year overall and disease-free survival was 50 and 21 months, respectively. Hepatic resection for metastatic urologic tumors is safe with low morbidity and mortality and durable long-term survival can be achieved. Liver resection for isolated hepatic disease should be considered for this rare metastatic disease to the liver.

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.

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