Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study

Liu, Kairui; Chen, Yajin; Wu, Xiaolin; Huang, Zeping; Lin, Zeyu; Jiang, Junliang; Tan, Wenliang; Zhang, Lei

doi:10.1007/s00464-017-5556-3

Cited by 45 publications

(66 citation statements)

References 42 publications

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“…No significant differences in terms of baseline patient characteristics, including tumor size were reported by the total of the studies. Furthermore, they all demonstrated a significantly lower blood loss rate in favor of RLLR, which resulted in decreased blood transfusion requirements and improved operative outcomes (Table II) (27,28,30). Operative time was significantly lower in one study (19) in favor of the laparoscopic approach with the rest of the studies demonstrating non-significant differences.…”

Section: Resultsmentioning

confidence: 94%

“…Operative time was significantly lower in one study (19) in favor of the laparoscopic approach with the rest of the studies demonstrating non-significant differences. Length of stay was significantly shorter, in 4 out of 5 studies, in the RLLR group (26)(27)(28)30). Postoperative morbidity was evaluated in 4 studies (26-28, 30) with 3 of them presenting a significantly decreased morbidity rate in the RLLR group when compared to ROLR.…”

Section: Resultsmentioning

confidence: 99%

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The Emerging Role of Laparoscopic Liver Resection in the Treatment of Recurrent Hepatocellular Carcinoma: A Systematic Review

Machairas

Papaconstantinou

Stamopoulos

et al. 2018

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

The Emerging Role of Laparoscopic Liver Resection in the Treatment of Recurrent Hepatocellular Carcinoma: A Systematic Review

Machairas

Papaconstantinou

Stamopoulos

et al. 2018

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“…However, the overall 5-year survival rate remains unsatisfactory. 2 Major challenges in treating HCC are the limitations of surgical management for patients with advanced HCC, high recurrence after surgery and the lack of efficient drugs with mild side effects. Sorafenib is the first targeted therapeutic agent available for advanced HCC and exerts antitumor effects by inhibiting tumor cell proliferation, preventing angiogenesis and inducing cell apoptosis.…”

Section: Introductionmentioning

confidence: 99%

<p>Oridonin Sensitizes Hepatocellular Carcinoma to the Anticancer Effect of Sorafenib by Targeting the Akt Pathway</p>

Chen

Liu

et al. 2020

CMAR

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Background Oridonin is the core bioactive component of Rabdosia rubescens , a traditional Chinese herbal medicine used in the treatment of hepatoma. Sorafenib, a targeted therapeutic agent for advanced hepatocellular carcinoma (HCC), has recently been shown to exert limited clinical effects. However, few studies have focused on the synergistic effect of these two drugs on hepatocellular carcinoma. Methods We treated different HCC cell lines with different concentrations of oridonin and sorafenib and assessed the viability by using MTT assays and examined proliferation, migration, invasion and apoptosis after cotreatment of HepG2 cells with 20 μM oridonin and 5 μM sorafenib via colony formation assays, Transwell assays and flow cytometry. Regulatory effects were measured by Western blotting. The in vivo synergistic effect was confirmed through xenograft tumor models, and tumor tissues were analyzed by immunohistochemistry. Results The inhibitory effects of oridonin and sorafenib cotreatment on HCC cells were stronger than those of either drug alone. In addition, combined treatment with the two drugs synergistically inhibited epithelial–mesenchymal transition and the Akt pathway but not NF-κB or MAPK signaling. Akt phosphorylation by SC79 reversed the inhibitory effects of the combined treatment. Synergistic inhibition was equally observed in vivo. Conclusion Oridonin combined with sorafenib synergistically inhibited proliferation, migration, invasion, and epithelial–mesenchymal transition and induced apoptosis by targeting the Akt pathway but not NF-κB or MAPK signaling.

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“…Finally, the minimally invasive of the abdominal wall could cause less bleeding in the LRLR and LPLR groups. [8,9,11,12,24,25] With respect to the intraoperative conversion, although Liu et al, [17] van der Poel et al [21] and Noda et al [19] reported some patients with the severe intra-abdominal adhesions were converted to open surgery, the pooled data suggested that the conversion rate was comparable between the LRLR and LPLR groups. These results indicated LRLR was safe during procedures, but it is noticeable that these LRLRs enrolled in this study were mainly performed by experienced surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…There are some limitations in our studies. First, although most of the included trials were conducted with case-matched, [13,14,16,17,20–22] in the absence of RCTs examining LRLR versus ORLR for recurrent tumors, selection bias regarding the selection of surgical approach was unavoidable. Second, some of the studies were not provided the important basic statistics, such as the surgical approach of previous hepatectomy and the grade of adhesions.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of laparoscopic repeat liver resection for recurrent liver cancer

et al. 2019

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Background:With the improvements of surgical instruments and surgeons’ experience, laparoscopic liver resection has been applied for recurrent tumors. However, the value of laparoscopic repeat liver resection (LRLR) is still controversial nowadays, which compelled us to conduct this meta-analysis to provide a comprehensive evidence about the efficacy of LRLR for recurrent liver cancer.Methods:A computerized search was performed to identify all eligible trials published up to April 2019. This meta-analysis was conducted to estimate the perioperative data and oncological outcomes of LRLR by compared with open repeat liver resection (ORLR) and laparoscopic primary liver resection (LPLR). A fixed or random-effect modal was established to collect the data.Results:A total of 1232 patients were included in this meta-analysis (LRLR: n = 364; ORLR: n = 396; LPLR: n = 472). LRLR did not increase the operative time compared to ORLR (WMD = 15.92 min; 95%CI: −33.53 to 65.37; P = .53). Conversely, LRLR for patients with recurrent tumors was associated with less intraoperative blood loss (WMD = −187.33 mL; 95%CI: −249.62 to −125.02; P < .00001), lower transfusion requirement (OR = 0.24; 95%CI: 0.06–1.03; P = .05), fewer major complications (OR = 0.42; 95%CI: 0.23–0.76; P = .004), and shorter hospital stays (WMD = −2.31; 95%CI: −3.55 to −1.07; P = .0003). In addition, the oncological outcomes were comparable between the two groups. However, as for the safety of LRLR compared with LPLR, although the operative time in LRLR group was longer than LPLR group (WMD = 58.63 min; 95%CI: 2.99–114.27; P = .04), the blood loss, transfusion rates, R0 resection, conversion, postoperative complications, and mortality were similar between the two groups.Conclusions:LRLR for recurrent liver cancer could be safe and feasible in selected patients when performed by experienced surgeons.

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Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study

Abstract: Laparoscopic liver re-resection for patients with posthepatectomy HCC recurrence provided comparable perioperative and oncological outcomes as open liver re-resection and can be a safe alternative to open procedure.

Cited by 45 publications

References 42 publications

The Emerging Role of Laparoscopic Liver Resection in the Treatment of Recurrent Hepatocellular Carcinoma: A Systematic Review

The Emerging Role of Laparoscopic Liver Resection in the Treatment of Recurrent Hepatocellular Carcinoma: A Systematic Review

<p>Oridonin Sensitizes Hepatocellular Carcinoma to the Anticancer Effect of Sorafenib by Targeting the Akt Pathway</p>

Outcomes of laparoscopic repeat liver resection for recurrent liver cancer

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