Reappraisal of the advantages of laparoscopic liver resection for intermediate hepatocellular carcinoma within a stage migration perspective: Propensity score analysis of the differential benefit.
benefit
hepatocellular carcinoma
laparoscopy
outcome
stage
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
09
12
2019
revised:
02
03
2020
accepted:
15
03
2020
pubmed:
20
3
2020
medline:
20
7
2021
entrez:
20
3
2020
Statut:
ppublish
Résumé
The aim of the present study was to analyze the outcome of laparoscopic approach specifically in patients with Intermediate-stage disease and to define the differential benefit with Early-stage patients. Six hundred twenty-two resections for HCC were dichotomized according to staging (Early and Intermediate) and to approach and then matched in a 1:1 ratio using propensity scores to obtain four groups (E-MILS and E-Open, including 104 patients respectively; Int-MILS and Int-Open, including 142 patients, respectively). The differential benefit associated with the minimally invasive technique was evaluated between intermediate-stage and early-stage patients taking into account blood loss and morbidity rate as outcome indicators. Laparoscopic approach resulted in a statistically significant lower blood loss, reduced morbidity, reduced incidence of hepatic decompensation and shorter time for functional recover and length of stay. The evaluation of the differential benefit showed a greater advantage of laparoscopic approach in Intermediate-stage patients compared with Early-stage patients, both in terms of blood loss and morbidity rate. The favorable biological scenario associated with laparoscopic approach allows to obtain enhanced benefits in the setting of more advanced liver disease. The push towards minimal invasiveness and the incremental benefit associated with it could potentially promote stage migration in suitable patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
510-521Informations de copyright
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
Références
Wallace MC, Preen D, Jeffrey GP, Adams LA. The evolving epidemiology of hepatocellular carcinoma: a global perspective. Expert Rev Gastroenterol Hepatol. 2015;9(6):765-79.
Cipriani F, Fantini C, Ratti F, Lauro R, Tranchart H, Halls M, et al. Laparoscopic liver resections for hepatocellular carcinoma. Can we extend the surgical indication in cirrhotic patients? Surg Endosc. 2018;32(2):617-26.
De Cobelli F, Marra P, Ratti F, Ambrosi A, Colombo M, Damascelli A, et al. Microwave ablation of liver malignancies: comparison of effects and early outcomes of percutaneous and intraoperative approaches with different liver conditions: new advances in interventional oncology: state of the art. Med Oncol. 2017;34(4):49.
Lai Q, Vitale A, Iesari S, Finkenstedt A, Mennini G, Spoletini G, et al. Intention-to-treat survival benefit of liver transplantation in patients with hepatocellular cancer. Hepatology. 2017;66(6):1910-9.
Ho SY, Liu PH, Hsu CY, Hsia CY, Su CW, Lee YH, et al. Comparison of twelve liver functional reserve models for outcome prediction in patients with hepatocellular carcinoma undergoing surgical resection. Sci Rep. 2018;8(1):4773.
Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19:329-38.
Galle PR, Forner A, Llovet JM, Mazzaferro V, Piscaglia F, Raoul JL, et al. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236.
Bruix J, Sherman M, American Association for the Study of Liver D. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020-2.
Torzilli G, Belghiti J, Kokudo N, Takayama T, Capussotti L, Nuzzo G, et al. A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations?: an observational study of the HCC East-West study group. Ann Surg. 2013;257(5):929-37.
Ettorre GM, Levi Sandri GB, Colasanti M, Mascianà G, de Werra E, Santoro R, et al. Liver resection for hepatocellular carcinoma ≥5 cm. Transl Gastroenterol Hepatol. 2017;2:22.
Kokudo T, Hasegawa K, Matsuyama Y, Takayama T, Izumi N, Kadoya M, et al. Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion. J Hepatol. 2016;65(5):938-43.
Ohkubo T, Midorikawa Y, Nakayama H, Moriguchi M, Aramaki O, Yamazaki S, et al. Liver resection of hepatocellular carcinoma in patients with portal hypertension and multiple tumors. Hepatol Res. 2018;48(6):433-41.
Levi Sandri GB, Ettorre GM, Aldrighetti L, Cillo U, Dalla Valle R, Guglielmi A, et al. Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry. Surg Endosc. 2019;33(5):1451-8.
Aldrighetti L, Guzzetti E, Pulitanò C, Cipriani F, Catena M, Paganelli M, et al. Case-matched analysis of totally laparoscopic versus open liver resection for HCC: short and middle term results. J Surg Oncol. 2010;102(1):82-6.
Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg. 2015;261(4):619-29.
Abu Hilal M, Aldrighetti L, Dagher I, Edwin B, Troisi RI, Alikhanov R, et al. The Southampton consensus guidelines for laparoscopic liver surgery: from indication to implementation. Ann Surg. 2018;268(1):11-8.
Patriti A, Cipriani F, Ratti F, Bartoli A, Ceccarelli G, Casciola L, et al. Robot-assisted versus open liver resection in the right posterior section. JSLS. 2014;18(3). pii: e2014.00040. https://doi.org10.4293/JSLS.2014.00040
de Franchis R, Faculty BVI. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63(3):743-52.
Qi X, Berzigotti A, Cardenas A, Sarin SK. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018;3(10):708-19.
Baig WW, Nagaraja MV, Varma M, Prabhu R. Platelet count to spleen diameter ratio for the diagnosis of esophageal varices: is it feasible? Can J Gastroenterol. 2008;22(10):825-8.
Dwivedi AK, Mallawaarachchi I, Alvarado LA. Analysis of small sample size studies using nonparametric bootstrap test with pooled resampling method. Stat Med. 2017;36(14):2187-205.
Aldrighetti L, Pulitanò C, Arru M, Catena M, Guzzetti E, Casati M, et al. Ultrasonic-mediated laparoscopic liver transection. Am J Surg. 2008;195(2):270-2.
Ratti F, Cipriani F, Reineke R, Catena M, Comotti L, Beretta L, et al. Impact of ERAS approach and minimally-invasive techniques on outcome of patients undergoing liver surgery for hepatocellular carcinoma. Dig Liver Dis. 2016;48(10):1243-8.
Ratti F, Cipriani F, Reineke R, Comotti L, Paganelli M, Catena M, et al. The clinical and biological impacts of the implementation of fast-track perioperative programs in complex liver resections: a propensity score-based analysis between the open and laparoscopic approaches. Surgery. 2018;164(3):395-403.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205-13.
Aldrighetti L, Ratti F, Cillo U, Ferrero A, Ettorre GM, Guglielmi A, et al. Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry. Updates Surg. 2017;69(3):271-83.
Ishizawa T, Hasegawa K, Aoki T, Takahashi M, Inoue Y, Sano K, et al. Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma. Gastroenterology. 2008;134(7):1908-16.
Shehta A, Han HS, Yoon YS, Cho JY, Choi Y. Laparoscopic liver resection for hepatocellular carcinoma in cirrhotic patients: 10-year single-center experience. Surg Endosc. 2016;30(2):638-48.
Halls MC, Cipriani F, Berardi G, Barkhatov L, Lainas P, Alzoubi M, et al. Conversion for unfavorable intraoperative events results in significantly worse outcomes during laparoscopic liver resection: lessons learned from a multicenter review of 2861 cases. Ann Surg. 2018;268(6):1051-7.
Fretland AA, Sokolov A, Postriganova N, Kazaryan AM, Pischke SE, Nilsson PH, et al. Inflammatory response after laparoscopic versus open resection of colorectal liver metastases: data from the Oslo-CoMet trial. Medicine (Baltimore). 2015;94(42):e1786.
Oba A, Ishizawa T, Mise Y, Inoue Y, Ito H, Ono Y, et al. Possible underestimation of blood loss during laparoscopic hepatectomy. BJS Open. 2019;3(3):336-43.