The largest western experience on salvage hepatectomy for recurrent hepatocellular carcinoma: propensity score-matched analysis on behalf of He.RC.O.Le.Study Group

Iaria, Maurizio; Bianchi, Giorgio; Fazio, Federico; Ardito, Francesco; Perri, Pasquale; Pontarolo, Nicholas; Conci, Simone; Donadon, Matteo; Zanello, Matteo; Lai, Quirino; Famularo, Simone; Molfino, Sarah; Sciannamea, Ivano; Fumagalli, Luca; Germani, Paola; Floridi, Antonio; Ferrari, Cecilia; Zimmitti, Giuseppe; Troci, Albert; Zago, Mauro; Ferraro, Valentina; Cipriani, Federica; Patauner, Stefan; Barba, Giuliano La; Romano, Maurizio; Zanus, Giacomo; Ercolani, Giorgio; Frena, Antonio; Aldrighetti, Luca; Méméo, Riccardo; Pinotti, Enrico; Crespi, Michele; Hilal, M. Abu; Griseri, G.; Tarchi, Paola; Chiarelli, Marco; Antonucci, Adelmo; Baiocchi, Gian Luca; Romano, Fabrizio; Rossi, Massimo; Jovine, Elio; Torzilli, Guido; Ruzzenente, Andrea; Maestri, Marcello; Grazi, Gian Luca; Giuliante, Felice; Ferrero, Alessandro; Valle, Raffaele Dalla; Giuffrida, Mario; Russolillo, Nadia; Razionale, Francesco; Peppo, Valerio De; Tomasoni, Matteo; Marchitelli, Ivan; Costa, Guido; Laureiro, Zoe Larghi; Scotti, Maddalena; Calcagno, Pietro; Cosola, Davide; Franceschi, Angelo; Manzoni, Alberto; Pennacchi, Luca; Montuori, Mauro; Conticchio, Maria; Ratti, Francesca; Notte, Francesca; Cucchetti, Alessandro; Salvador, Laura; Corleone, Pio; Garancini, Mattia; Ciulli, Cristina

doi:10.1016/j.hpb.2022.01.001

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…In case of tumor recurrence, the case was re‐examined by a multidisciplinary team (MDT) with the aim of carrying out curative treatment as much as possible. The first therapeutic strategy for localized recurrent HCC was repeat hepatectomy, according to previous studies that have shown the same OS and DFS as primary liver resection 28 . In cases where liver resection was not indicated because of liver, as well as tumor or patient status, other locoregional therapies represented the second choice.…”

Section: Methodsmentioning

confidence: 99%

“…The first therapeutic strategy for localized recurrent HCC was repeat hepatectomy, according to previous studies that have shown the same OS and DFS as primary liver resection. 28 In cases where liver resection was not indicated because of liver, as well as tumor or patient status, other locoregional therapies represented the second choice. a Also including more than one anatomical segmentectomy.…”

Section: Postoperative Management and Follow-upmentioning

confidence: 99%

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Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Cassese,

Han,

Lee

et al. 2023

J Hepato Biliary Pancreat

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BackgroundThere is still little knowledge about the outcomes of laparoscopic liver resection (LLR) for multiple hepatocellular carcinomas (HCC). The aim of this study was to assess the short‐ and long‐ term outcomes of LLR versus open liver resection (OLR) for patients with multiple HCC within and beyond the Milan criteria, and in both BCLC‐A and ‐B stage.MethodsData regarding all consecutive patients undergoing liver resection for multiple HCC were retrospectively collected from Asian (South Korean) and European (Italian) referral HPB centers. The cases were propensity‐score matched for age, BMI, center, extent of the resection, postero‐superior location of the lesion, underlying liver condition, BCLB staging and the Milan criteria.ResultsA total of 203 patients were included in the study: 27% of patients had undergone hemi‐hepatectomy, 26.6% atypical resections, 20.6% sectionectomy and 16.2% segmentectomy. After PSM two cohorts of 57 patients were obtained, with no significant differences in all preoperative characteristics. The length of hospital stay was significantly lower after LLR (median 7 vs. 9 days, p < .01), with no statistically significant differences in estimated blood loss, operation time, transfusions, postoperative bile leak, ascites, severe complications and R1 resection rates. After a median follow‐up of 61 (±7) months, there were no significant differences between OLR and LLR in both median OS (69 vs. 59 months, p = .74, respectively) and median DFS (12 vs. 10 months, p = .48, respectively).ConclusionLLR for multiple HCC can be safe and effective in selected cases and is able to shorten median hospital stay without affecting perioperative and long‐term oncological outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Postoperative Management and Follow-upmentioning

confidence: 99%

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Cassese,

Han,

Lee

et al. 2023

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

show abstract

“…Since then, thanks to the advances in both surgical techniques and perioperative care, RH is now considered a feasible option in the management of recurrent liver tumors ( 103 , 104 ). Indeed, a recent wide PSM study enrolling 2,689 patients showed how RH has the same OS and DFS as primary LR ( 105 ). Interestingly, at multivariate analysis MVI was the only independent prognostic factor for OS.…”

Section: Management and Curative Treatments Of Hcc Recurrencementioning

confidence: 99%

Management of hepatocellular carcinoma recurrence after liver surgery and thermal ablations: state of the art and future perspectives

Herrero,

Toubert,

Bedoya

et al. 2024

Hepatobiliary Surg Nutr

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Despite the improvements in surgical and medical therapy for hepatocellular carcinoma (HCC), recurrence still represents a major issue. Up to 70% of patients can experience HCC recurrence after liver resection (LR), as well as 20% of them even after liver transplantation (LT). The patterns of recurrence are different according to both the time and the location. Similarly, the risk factors and the management can change not only according to these patterns, but also according to the underlying liver condition and to the first treatment performed. Deep knowledge of such correlation is fundamental, since prevention and effective management of recurrence are undoubtedly the most important strategies to improve the outcomes of HCC treatment. Without adjuvant therapy, maintaining very close monitoring during the first 2 years in order to diagnose curable recurrence and continue this monitoring beyond 5 years because late recurrences exist, remains our only possibility today. Surgery represents the cornerstone treatment for HCC, including both LT and LR. However, new interesting therapeutic opportunities are coming from immunotherapy that has shown encouraging results also in the adjuvant setting. In such a complex and evolutionary scenario, the aim of this review is to summarize current strategies for the management of HCC recurrence, focusing on the different possible scenarios, as well as on future perspectives

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Laparoscopic versus open liver resection for huge hepatocellular carcinoma (≥ than 10 cm): a retrospective analysis from a high-volume referral center

Cassese,

Han,

Lee

et al. 2024

Surg Endosc

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Background There is still poor evidence about the safety and feasibility of laparoscopic liver resection (LLR) for huge (> 10 cm) hepatocellular carcinomas (HCC). The aim of this study was to assess the short- and long-term outcomes of LLR versus open liver resection (OLR) for patients with huge HCC from real-life data from consecutive patients. Methods Data regarding all consecutive patients undergoing liver resection for huge HCC were retrospectively collected from a Korean referral HPB center. Primary outcomes were the postoperative results, while secondary outcomes were the oncologic survivals. Results Sixty-three patients were included in the study: 46 undergoing OLR and 17 LLR. Regarding postoperative outcomes, there were no statistically significant differences in estimated blood loss, operation time, transfusions, postoperative bile leak, ascites, severe complications, and R1 resection rates. After a median follow-up of 48.4 (95% CI 8.9–86.8) months, there were no statistically significant differences in 3 years OS (59.3 ± 8.7 months vs. 85.2 ± 9.8 months) and 5 years OS (31.1 ± 9 months vs. 73.1 ± 14.1 months), after OLR and LLR, respectively (p = 0.10). Similarly, there was not a statistically significant difference in both 3 years DFS (23.5% ± 8.1 months vs. 51.6 ± months) and 5 years DFS (15.7 ± 7.1 months vs. 38.7 ± 15.3 months), respectively (p = 0.13), despite a potential clinically significant difference. Conclusion LLR for huge HCC may be safe and effective in selected cases. Further studies with larger sample size and more appropriate design are needed to confirm these results. Graphical abstract

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The largest western experience on salvage hepatectomy for recurrent hepatocellular carcinoma: propensity score-matched analysis on behalf of He.RC.O.Le.Study Group

Cited by 3 publications

References 36 publications

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Management of hepatocellular carcinoma recurrence after liver surgery and thermal ablations: state of the art and future perspectives

Laparoscopic versus open liver resection for huge hepatocellular carcinoma (≥ than 10 cm): a retrospective analysis from a high-volume referral center

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