Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC - B and - C: an Italian multicentric analysis.

• Tác giả: Mohamed Abu Hilal, Luca Aldrighetti, Francesco Ardito, Gianluca Baiocchi, Andrea Belli, Luigi Boccia, Mariano C Giglio, Gianluca Cassese, Matteo Cescon, Marco Chiarelli, Umberto Cillo, Federica Cipriani, Simone Conci, Maria Conticchio, Michele Crespi, Michela De Angelis, Luciano De Carlis, Raffaele Della Valle, Giulio Di Gioia, Giorgio Ercolani, Simone Famularo, Alessandro Ferrero, Andrea Pierluigi Fontana, Luca Fumagalli, Mattia Garancini, Paola Germani, Felice Giuliante, Gian Luca Grazi, Roberto I Troisi, Maurizio Iaria, Francesco Izzo, Elio Jovine, Giuliano La Barba, Quirino Lai, Andrea Lauterio, Marcello Maestri, Riccardo Memeo, Sarah Molfino, Daniele Nicolini, Pasquale Perri, Fabrizio Romano, Maurizio Romano, Massimo Rossi, Andrea Ruzzenente, Matteo Serenari, Paola Tarchi, Guido Torzilli, Albert Troci, Alessandro Vitale, Marco Vivarelli, Matteo Zanello, Giacomo Zanus, Giuseppe Zimmitti
• Ngôn ngữ: eng
• Ký hiệu phân loại: 615.367 Liver extracts
• Thông tin xuất bản: England : HPB : the official journal of the International Hepato Pancreato Biliary Association , 2025
• Bộ sưu tập: NCBI
• ID: 166750

Tóm tắt

 BACKGROUND: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far. METHODS: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality. RESULTS: 627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]
  p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]
  p <
  0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]
  p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]
  p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491). CONCLUSION: MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.