Postoperative Outcomes in Patients With Hepatocellular Carcinomas Resected With Exposure of the Tumor Surface

Matsui, Yoshihiko; Terakawa, N.; Satoi, Sohei; Kaibori, Masaki; Kitade, Hiroaki; Takai, Soichiro; Kwon, A‐Hon; Kamiyama, Yasuo

doi:10.1001/archsurg.142.7.596

Cited by 82 publications

(54 citation statements)

References 35 publications

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“…From the oncological standpoint, many studies have previously reported that the width of the surgical margin was not correlated with the true recurrence rate [24,25]. In particular, the zero margin in the case of hepatocellular carcinoma did not increase the risk of recurrence as shown by our previous reports [10,11], and as recently confirmed by Matsui et al [25] in a large series of patients. On the other hand, also in the case of liver metastases, the 0-mm margin is progressively becoming acceptable [26,27].…”

Section: Discussionsupporting

confidence: 57%

From Mesohepatectomy to Mini-Mesohepatectomy: Evolving the Concept of Resectability of Hepatic Tumors at the Hepatocaval Confluence

Donadon

Torzilli

2011

Dig Surg

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In the case of tumors in contact with or invading the middle hepatic vein (MHV) at the hepatocaval confluence, extended right hepatectomy or mesohepatectomy is usually recommended. Major or extended hepatectomy is associated with significant rates of morbidity and mortality, and a more conservative approach would be desirable. Thus, we developed a new conservative operation, the so-called mini-mesohepatectomy that, in some specific circumstances, allowed the en-bloc resection of segment 8, segment 4-sup and the MHV at the hepatocaval confluence and at the same time preservation of the remaining parenchyma of the right anterior section and left median section drained by the MHV. The present work describes the rationale, indications, as well as the surgical technique of this new operation which we believe should be part of the armamentarium of the modern hepatic surgeon, and will probably limit the need for a formal mesohepatectomy.

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Section: Discussionsupporting

confidence: 57%

From Mesohepatectomy to Mini-Mesohepatectomy: Evolving the Concept of Resectability of Hepatic Tumors at the Hepatocaval Confluence

Donadon

Torzilli

2011

Dig Surg

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“…They showed no significant difference in the oncologic outcomes among patients divided by RM, but patients with a wide RM experienced more frequent postoperative complications compared with patients with a narrow RM [7]. Matsui et al[23] also found no differences in the oncologic outcomes or recurrence patterns between patients with tumor tissue exposed at the cut surface and patients without tumor tissue exposure in their study, and they proposed that intrahepatic metastasis is based on portal venous dissemination or multicentric carcinogenesis. A recent retrospective study emphasized the importance of anatomic resection rather than a sufficient RM [24].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

et al. 2018

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Background: The relationship between resection margin (RM) and recurrence of resected hepatocellular carcinoma (HCC) is unclear. Methods: We reviewed clinical data for 419 patients with HCC. The oncologic outcomes were compared between 2 groups of patients classified according to the inflexion point of the restricted cubic spline plot. Results: The patients were divided according to an RM of <1 cm (n = 233; narrow RM group) or ≥1 cm (n = 186; wide RM group). The 5-year recurrence-free survival (RFS) rate was lower (34.8 vs. 43.8%, p = 0.042) and recurrence near the resection site was more frequent (4.7 vs. 0%, p = 0.010) in the narrow RM group. Patients with multiple lesions, or prior transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) were excluded from subgroup analyses. In patients with a 2–5 cm HCC, the 5-year RFS was greater in the wide RM group (54.4 vs. 32.5%, p = 0.036). Narrow RM (hazard ratio 1.750, 95% CI 1.029–2.976, p = 0.039) was independently associated with disease recurrence. Conclusion: In patients with a single 2–5 cm HCC without prior TACE/RFA, an RM of ≥1 cm was associated with lower risk of recurrence after liver resection.

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“…In both groups of patients, when the tumor was in close contact with a major liver vessel, the operative strategy was defined at the laparoscopic intraoperative ultrasonography (LIOUS), according to the criteria of Torzilli et al [13]. If the portal branch or the hepatic vein was separated by a thin layer of liver parenchyma from the lesion or was in contact with the lesion without vessel wall discontinuation, with contact \1/3 of the vessel diameter, the vessel was spared and limited resection with no margin was performed [13,14]. In all other conditions, vessel resection was carried out.…”

Section: Techniquementioning

confidence: 99%

Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments

et al. 2011

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Postoperative Outcomes in Patients With Hepatocellular Carcinomas Resected With Exposure of the Tumor Surface

Cited by 82 publications

References 35 publications

From Mesohepatectomy to Mini-Mesohepatectomy: Evolving the Concept of Resectability of Hepatic Tumors at the Hepatocaval Confluence

From Mesohepatectomy to Mini-Mesohepatectomy: Evolving the Concept of Resectability of Hepatic Tumors at the Hepatocaval Confluence

Correlation between Resection Margin and Disease Recurrence with a Restricted Cubic Spline Model in Patients with Resected Hepatocellular Carcinoma

Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments

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