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2. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author

Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P. H., Rinkes, I. H. M. Borel, Breitenstein, S., Bruijnen, R. C. G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K. Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Å., Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K. G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L. J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A. J., Binkert, C. A., Bemelmans, M. H. A., van der Leij, C., Schadde, E., and van Dam, R. M.

Published
2022
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3. Dynamic surgical anatomy using 3D reconstruction technology in complex hepato-biliary surgery with vascular involvement. Results from an international multicentric survey

Author

Cotsoglou, C, Granieri, S, Bassetto, S, Bagnardi, V, Pugliese, R, Grazi, G, Guglielmi, A, Ruzzenente, A, Aldrighetti, L, Ratti, F, De Carlis, L, De Carlis, R, Centonze, L, De Angelis, N, Memeo, R, Delvecchio, A, Felli, E, Izzo, F, Belli, A, Patrone, R, Ettorre, G, Berardi, G, Di Benedetto, F, Di Sandro, S, Romano, F, Garancini, M, Scotti, M, Bianchi, G, Germini, A, Gjoni, E, Bonomi, A, Bruno, F, Paleino, S, Pugliese, G, Cotsoglou C., Granieri S., Bassetto S., Bagnardi V., Pugliese R., Grazi G. L., Guglielmi A., Ruzzenente A., Aldrighetti L., Ratti F., De Carlis L., De Carlis R., Centonze L., De Angelis N., Memeo R., Delvecchio A., Felli E., Izzo F., Belli A., Patrone R., Ettorre G. M., Berardi G., Di Benedetto F., Di Sandro S., Romano F., Garancini M., Scotti M. A., Bianchi G., Germini A., Gjoni E., Bonomi A., Bruno F., Paleino S., Pugliese G., Cotsoglou, C, Granieri, S, Bassetto, S, Bagnardi, V, Pugliese, R, Grazi, G, Guglielmi, A, Ruzzenente, A, Aldrighetti, L, Ratti, F, De Carlis, L, De Carlis, R, Centonze, L, De Angelis, N, Memeo, R, Delvecchio, A, Felli, E, Izzo, F, Belli, A, Patrone, R, Ettorre, G, Berardi, G, Di Benedetto, F, Di Sandro, S, Romano, F, Garancini, M, Scotti, M, Bianchi, G, Germini, A, Gjoni, E, Bonomi, A, Bruno, F, Paleino, S, Pugliese, G, Cotsoglou C., Granieri S., Bassetto S., Bagnardi V., Pugliese R., Grazi G. L., Guglielmi A., Ruzzenente A., Aldrighetti L., Ratti F., De Carlis L., De Carlis R., Centonze L., De Angelis N., Memeo R., Delvecchio A., Felli E., Izzo F., Belli A., Patrone R., Ettorre G. M., Berardi G., Di Benedetto F., Di Sandro S., Romano F., Garancini M., Scotti M. A., Bianchi G., Germini A., Gjoni E., Bonomi A., Bruno F., Paleino S., and Pugliese G.

Abstract

Introduction: Three-dimensional liver modeling can lead to substantial changes in choosing the type and extension of liver resection. This study aimed to explore whether 3D reconstruction helps to better understand the relationship between liver tumors and neighboring vascular structures compared to standard 2D CT scan images. Methods: Contrast-enhanced CT scan images of 11 patients suffering from primary and secondary hepatic tumors were selected. Twenty-three experienced HBP surgeons participated to the survey. A standardized questionnaire outlining 16 different vascular structures (items) having a potential relationship with the tumor was provided. Intraoperative and histopathological findings were used as the reference standard. The proper hypothesis was that 3D accuracy is greater than 2D. As a secondary endpoint, inter-raters’ agreement was explored. Results: The mean difference between 3D and 2D, was 2.6 points (SE: 0.40; 95 % CI: 1.7–3.5; p < 0.0001). After sensitivity analysis, the results favored 3D visualization as well (mean difference 1.7 points; SE: 0.32; 95 % CI: 1.0–2.5; p = 0.0004). The inter-raters’ agreement was moderate for both methods (2D: W = 0.45; 3D: W = 0.44). Conclusion: 3D reconstruction may give a significant contribution to better understanding liver vascular anatomy and the precise relationship between the tumor and the neighboring structures.

Published
2024

4. Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis

Author

Rimini, M., Rimassa, L., Ueshima, K., Burgio, V., Shigeo, S., Tada, T., Suda, G., Yoo, C., Cheon, J., Pinato, D.J., Lonardi, S., Scartozzi, M., Iavarone, M., Di Costanzo, G.G., Marra, F., Soldà, C., Tamburini, E., Piscaglia, F., Masi, G., Cabibbo, G., Foschi, F.G., Silletta, M., Pressiani, T., Nishida, N., Iwamoto, H., Sakamoto, N., Ryoo, B.-Y., Chon, H.J., Claudia, F., Niizeki, T., Sho, T., Kang, B., D’Alessio, A., Kumada, T., Hiraoka, A., Hirooka, M., Kariyama, K., Tani, J., Atsukawa, M., Takaguchi, K., Itobayashi, E., Fukunishi, S., Tsuji, K., Ishikawa, T., Tajiri, K., Ochi, H., Yasuda, S., Toyoda, H., Ogawa, C., Nishimur, T., Hatanaka, T., Kakizaki, S., Shimada, N., Kawata, K., Tanaka, T., Ohama, H., Nouso, K., Morishita, A., Tsutsui, A., Nagano, T., Itokawa, N., Okubo, T., Arai, T., Imai, M., Naganuma, A., Koizumi, Y., Nakamura, S., Joko, K., Iijima, H., Hiasa, Y., Pedica, F., De Cobelli, F., Ratti, F., Aldrighetti, L., Kudo, M., Cascinu, S., and Casadei-Gardini, A.

Published
2022
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5. Real-Life Clinical Data of Lenvatinib versus Sorafenib for Unresectable Hepatocellular Carcinoma in Italy

Author

Burgio V, Iavarone M, Di Costanzo GG, Marra F, Lonardi S, Tamburini E, Piscaglia F, Masi G, Celsa C, Foschi FG, Silletta M, Amoruso DC, Rimini M, Bruccoleri M, Tortora R, Campani C, Soldà C, Viola MG, Forgione A, Conti F, Salani F, Catanese S, Giacchetto CM, Fulgenzi C, Coppola C, Lampertico P, Pellino A, Rancatore G, Cabibbo G, Ratti F, Pedica F, Della Corte A, Colombo M, De Cobelli F, Aldrighetti L, Cascinu S, and Casadei-Gardini A

Subjects
hepatocarcinoma, sorafenib, lenvatinib, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Valentina Burgio,1 Massimo Iavarone,2 Giovanni Giuseppe Di Costanzo,3 Fabio Marra,4 Sara Lonardi,5,6 Emiliano Tamburini,7 Fabio Piscaglia,8 Gianluca Masi,9,10 Ciro Celsa,11 Francesco Giuseppe Foschi,12 Marianna Silletta,13 Daniela Caterina Amoruso,14 Margherita Rimini,15 Mariangela Bruccoleri,2 Raffaella Tortora,3 Claudia Campani,4 Caterina Soldà,6 Massimo Giuseppe Viola,16 Antonella Forgione,8 Fabio Conti,12 Francesca Salani,9,10 Silvia Catanese,9,10 Carmelo Marco Giacchetto,17 Claudia Fulgenzi,13 Carmine Coppola,14 Pietro Lampertico,18 Antonio Pellino,6,19 Gabriele Rancatore,17 Giuseppe Cabibbo,17 Francesca Ratti,20 Federica Pedica,21 Angelo Della Corte,22 Massimo Colombo,18 Francesco De Cobelli,23 Luca Aldrighetti,20 Stefano Cascinu,1,23 Andrea Casadei-Gardini1,23 1Department of Medical Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy; 2Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy; 3Department of Hepatology, Naples, 80131, Italy; 4Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy; 5Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; 6Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 7Department of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy; 8Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 9Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; 10Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; 11Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, 90127, Italy; 12Internal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy; 13Department of Oncology, Campus Bio Medico, Roma, Italy; 14Hepatology Unit, Internal Medicine, Area Stabiese Hospital, Naples, Italy; 15Department of Oncology and Hematology, Division of Oncology, University of Modena and Reggio Emilia, Modena, 4121, Italy; 16Department of General Surgery and Emergency Surgery, Cardinale Hospital, Tricase, Italy; 17Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, 90127, Italy; 18Liver Center, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy; 19Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; 20Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy; 21Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy; 22Department of Radiology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy; 23School of Medicine, Vita-Salute San Raffaele University, Milan, 20132, ItalyCorrespondence: Andrea Casadei-GardiniDepartment of Medical Oncology, IRCCS San Raffaele Hospital, Via Olgettina n. 60, Milan, ItalyEmail casadeigardini@gmail.comBackground: Lenvatinib has been approved in Italy since October 2019 as a first-line therapy for advanced hepatocellular carcinoma (HCC) and to date data on effectiveness and safety of lenvatinib are not available in our region. To fill this gap, we performed a multicentric analysis of the real-world treatment outcomes with the propensity score matching in a cohort of Italian patients with unresectable HCC who were treated with either sorafenib or lenvatinib.Aims and Methods: To evaluate the effectiveness of sorafenib and lenvatinib as primary treatment of advanced HCC in clinical practice we performed a multicentric analysis of the treatment outcomes of 288 such patients recruited in 11 centers in Italy. A propensity score was used to mitigate confounding due to referral biases in the assessment of mortality and progression-free survival.Results: Over a follow-up period of 11 months the Cox regression model showed 48% reduction of death risk for patients treated with lenvatinib (95% CI: 0.34– 0.81; p = 0.0034), compared with those treated with sorafenib. The median PFS was 9.0 and 4.9 months for lenvatinib and sorafenib arm, respectively. Patients treated with lenvatinib showed a higher percentage of response rate (29.4% vs 2.8%; p < 0.00001) compared with patients treated with sorafenib. Sorafenib was shown to be correlated with more HFSR, diarrhea and fatigue, while lenvatinib with more hypertension and fatigue.Conclusion: Our study highlighted for the first time the efficacy and safety of lenvatinib in an Italian cohort of patients.Keywords: hepatocarcinoma, sorafenib, lenvatinib

Published
2021

6. Nonalcoholic steatohepatitis in hepatocarcinoma: new insights about its prognostic role in patients treated with lenvatinib

Author

Rimini, M., Kudo, M., Tada, T., Shigeo, S., Kang, W., Suda, G., Jefremow, A., Burgio, V., Iavarone, M., Tortora, R., Marra, F., Lonardi, S., Tamburini, E., Piscaglia, F., Masi, G., Cabibbo, G., Foschi, F.G., Silletta, M., Kumada, T., Iwamoto, H., Aoki, T., Goh, M.J., Sakamoto, N., Siebler, J., Hiraoka, A., Niizeki, T., Ueshima, K., Sho, T., Atsukawa, M., Hirooka, M., Tsuji, K., Ishikawa, T., Takaguchi, K., Kariyama, K., Itobayashi, E., Tajiri, K., Shimada, N., Shibata, H., Ochi, H., Yasuda, S., Toyoda, H., Fukunishi, S., Ohama, H., Kawata, K., Tani, J., Nakamura, S., Nouso, K., Tsutsui, A., Nagano, T., Takaaki, T., Itokawa, N., Okubo, T., Arai, T., Imai, M., Joko, K., Koizumi, Y., Hiasa, Y., Cucchetti, A., Ratti, F., Aldrighetti, L., Cascinu, S., and Casadei-Gardini, A.

Published
2021
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10. OC.09.6: SURGERY VERSUS ENDOSCOPIC THERAPY FOR MIRIZZI SYNDROME (SEIZE)-STUDY: A MULTICENTRE INTERNATIONAL EXPERIENCE

Author

Bronswijk, M., primary, Tengan, J., additional, Vanella, G., additional, Arcidiacono, P.G., additional, Bruno, M.J., additional, Cipriani, F., additional, Dhar, J., additional, Everett, S., additional, Gerges, C., additional, Gauci, J., additional, Gupta, V., additional, Hollenbach, M., additional, Johnson, G., additional, Lakhtakia, S., additional, Laleman, W., additional, Lammers, W., additional, Lemmers, A., additional, Omoshoro–Jones, J., additional, Ouazzani, S., additional, Papaefthymiou, A., additional, Pérez–Cuadrado-Robles, E., additional, Prat, F., additional, Rahe, G., additional, Reddy, N., additional, Saelman, G., additional, Samanta, J., additional, Aldrighetti, L., additional, Vermeiren, K., additional, Vila, J., additional, Van Malenstein, H., additional, Waldthaler, A., additional, Van Wanrooij, R.L.J., additional, Zonderhuis, B.M., additional, Kunda, R., additional, Webster, G., additional, and S., Van Der Merwe, additional

Published
2024
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12. BOC.04.3: PREDICTING THE NEED FOR STEP-UP AFTER EUS-GUIDED DRAINAGE OF PERIPANCREATIC FLUID COLLECTIONS, INCLUDING QNI SCORE VALIDATION: A PROSPECTIVE COHORT STUDY

Author

Vanella, G., primary, Leone, R., additional, Dell'Anna, G., additional, Rossi, G., additional, Guazzarotti, G., additional, Palumbo, D., additional, Preatoni, P., additional, Aldrighetti, L., additional, Falconi, M., additional, Capurso, G., additional, and Arcidiacono, P.G., additional

Published
2024
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13. OC.10.4: EUS-GUIDED DRAINAGE OF POST-SURGICAL VERSUS POSTPANCREATITIS COLLECTIONS (RESPELL): A PROSPECTIVE COMPARISON OF CLINICAL PRESENTATIONS AND THERAPEUTIC OUTCOMES

Author

Vanella, G., primary, Leone, R., additional, Dell'Anna, G., additional, Rossi, G., additional, Preatoni, P., additional, Guazzarotti, G., additional, Palumbo, D., additional, Aldrighetti, L., additional, Falconi, M., additional, Capurso, G., additional, and Arcidiacono, P.G., additional

Published
2024
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15. Open vs minimally invasive liver surgery for gallbladder cancer, an Italian registry-based analysis

Author

Poletto, E., primary, Conci, S., additional, Ettorre, G.M., additional, Cillo, U., additional, Belli, A., additional, Giuliante, F., additional, Jovine, E., additional, Vennarecci, G., additional, Frena, A., additional, Ferrero, A., additional, Gruttadauria, S., additional, Ercolani, G., additional, Di Benedetto, F., additional, Brolese, A., additional, Dalla Valle, R., additional, Ettore Rossi, G., additional, Barabino, M., additional, Filauro, M., additional, Morelli, L., additional, Massani, M., additional, Vincenti, L., additional, Aldrighetti, L., additional, and Ruzzenente, A., additional

Published
2024
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16. Clinical and molecular characterization of early onset intrahepatic cholangiocarcinoma

Author

Tsilimigras, D.I., primary, Han, X., additional, Munir, M.M., additional, Guglielmi, A., additional, Aldrighetti, L., additional, Weiss, M., additional, Bauer, T.W., additional, Alexandrescu, S., additional, Poultsides, G.A., additional, Maithel, S.K., additional, Marques, H.P., additional, Martel, G., additional, Pulitano, C., additional, Shen, F., additional, Cauchy, F., additional, Koerkamp, B.G., additional, Endo, I., additional, Sasaki, K., additional, Aucejo, F., additional, Zhang, X.F., additional, Zhu, H., additional, and Pawlik, T.M., additional

Published
2024
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17. Perioperative changes of serum transaminase levels following hepatic resection for liver cancer

Author

Wang, F., primary, Guglielmi, A., additional, Ruff, S.M., additional, Aldrighetti, L., additional, Weiss, M., additional, Bauer, T., additional, Alexandrescu, S., additional, Poultsides, G., additional, Maithel, S., additional, Marques, H., additional, Martel, G., additional, Pulitano, C., additional, Shen, F., additional, Chaucy, F., additional, Koerkamp, B.G., additional, Endo, I., additional, Sasaki, K., additional, Aucejo, F., additional, Zhang, X.-F., additional, and Pawlik, T.M., additional

Published
2024
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19. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., Conticchio M., Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., and Conticchio M.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

20. Multisocietal European consensus on the terminology, diagnosis, and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE

Author

Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, K, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Lang, H, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef K., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Lang H., Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F. M., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., Artigas C., Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, K, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Lang, H, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef K., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Lang H., Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F. M., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., and Artigas C.

Abstract

Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods: This project was a multiorganizational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis, and management. Statements were refined during an online Delphi process, and those with 70 per cent agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising 12 key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term 'early metachronous metastases' applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour, the term 'late metachronous metastases' applies to those detected after 12 months. 'Disappearing metastases' applies to lesions that are no longer detectable on MRI after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards, and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways, including systemic chemotherapy, synchronous surgery, and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusion: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.

Published
2023

21. The multi-societal European consensus on the terminology, diagnosis and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE

Author

Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, C, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Hauke, L, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef C., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Hauke Lang, Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., Artigas C., Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, C, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Hauke, L, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef C., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Hauke Lang, Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., and Artigas C.

Abstract

Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases with a focus on terminology, diagnosis and management. Methods: This project was a multi-organisational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis and management. Statements were refined during an online Delphi process and those with 70% agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising twelve key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term “early metachronous metastases” applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour with “late metachronous metastases” applied to those detected after 12 months. Disappearing metastases applies to lesions which are no longer detectable on MR scan after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways including systemic chemotherapy, synchronous surgery and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusions: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.

Published
2023

22. Survival benefit of second line therapies for recurrent hepatocellular carcinoma: repeated hepatectomy, thermoablation and second-line transplant referral in a real life national scenario

Author

Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., Bernasconi D. P., Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., and Bernasconi D. P.

Abstract

Background: Despite second-line transplant(SLT) for recurrent hepatocellular carcinoma(rHCC) leads to the longest survival after recurrence(SAR), its real applicability has never been reported. The aim was to compare the SAR of SLT versus repeated hepatectomy and thermoablation(CUR group). Methods: Patients were enrolled from the Italian register HE.RC.O.LE.S. between 2008 and 2021. Two groups were created: CUR versus SLT. A propensity score matching (PSM) was run to balance the groups. Results: 743 patients were enrolled, CUR = 611 and SLT = 132. Median age at recurrence was 71(IQR 6575) years old and 60(IQR 53-64, p < 0.001) for CUR and SLT respectively. After PSM, median SAR for CUR was 43 months(95%CI = 37 – 93) and not reached for SLT(p < 0.001). SLT patients gained a survival benefit of 9.4 months if compared with CUR. MilanCriteria(MC)-In patients were 82.7% of the CUR group. SLT(HR 0.386, 95%CI = 0.23 – 0.63, p < 0.001) and the MELD score(HR 1.169, 95%CI = 1.07 – 1.27, p < 0.001) were the only predictors of mortality. In case of MC-Out, the only predictor of mortality was the number of nodules at recurrence(HR 1.45, 95%CI= 1.09 – 1.93, p = 0.011). Conclusion: It emerged an important transplant under referral in favour of repeated hepatectomy or thermoablation. In patients with MC-Out relapse, the benefit of SLT over CUR was not observed.

Published
2023

23. Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry

Author

Serenari, M, Ratti, F, Guglielmo, N, Zanello, M, Mocchegiani, F, Lenzi, J, Colledan, M, Mazzaferro, V, Cillo, U, Ferrero, A, Cescon, M, Di Benedetto, F, Massani, M, Grazi, G, Valle, R, Vivarelli, M, Ettorre, G, Aldrighetti, L, Jovine, E, Serenari M., Ratti F., Guglielmo N., Zanello M., Mocchegiani F., Lenzi J., Colledan M., Mazzaferro V., Cillo U., Ferrero A., Cescon M., Di Benedetto F., Massani M., Grazi G., Valle R. D., Vivarelli M., Ettorre G. M., Aldrighetti L., Jovine E., Serenari, M, Ratti, F, Guglielmo, N, Zanello, M, Mocchegiani, F, Lenzi, J, Colledan, M, Mazzaferro, V, Cillo, U, Ferrero, A, Cescon, M, Di Benedetto, F, Massani, M, Grazi, G, Valle, R, Vivarelli, M, Ettorre, G, Aldrighetti, L, Jovine, E, Serenari M., Ratti F., Guglielmo N., Zanello M., Mocchegiani F., Lenzi J., Colledan M., Mazzaferro V., Cillo U., Ferrero A., Cescon M., Di Benedetto F., Massani M., Grazi G., Valle R. D., Vivarelli M., Ettorre G. M., Aldrighetti L., and Jovine E.

Abstract

Background: Since 2012, Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has encountered several modifications of its original technique. The primary endpoint of this study was to analyze the trend of ALPPS in Italy over a 10-year period. The secondary endpoint was to evaluate factors affecting the risk of morbidity/mortality/post-hepatectomy liver failure (PHLF). Methods: Data of patients submitted to ALPPS between 2012 and 2021 were identified from the ALPPS Italian Registry and evaluation of time trends was performed. Results: From 2012 to 2021, a total of 268 ALPPS were performed within 17 centers. The number of ALPPS divided by the total number of liver resections performed by each center slightly declined (APC = - 2.0%, p = 0.111). Minimally invasive (MI) approach significantly increased over the years (APC = + 49.5%, p = 0.002). According to multivariable analysis, MI completion of stage 1 was protective against 90-day mortality (OR = 0.05, p = 0.040) as well as enrollment within high-volume centers for liver surgery (OR = 0.32, p = 0.009). Use of interstage hepatobiliary scintigraphy (HBS) and biliary tumors were independent predictors of PHLF. Conclusions: This national study showed that use of ALPPS only slightly declined over the years with an increased use of MI techniques, leading to lower 90-day mortality. PHLF still remains an open issue.

Published
2023

24. Are the current difficulty scores for laparoscopic liver surgery telling the whole story? An international survey and recommendations for the future

Author

Abu Hilal, M., Aldrighetti, L., Al Saati, H., Alseidi, A., Aroori, S., Belli, G., Besselink, M., Edwin, B., D'Hondt, M., Dagher, I., Dejong, C., Geller, D., Hamady, Z., Hamoui, M., Isaksson, B., Ivanecz, A., Le Roux, G., Lesurtel, M., O'Rouke, N., Prasad, R., Prieto Calvo, M., Reddy, S., Rotellar, F., Santoyo, J., Soonawalla, Z., Soubrane, O., Stavrou, G., Subar, D., Sutcliffe, R., Tanis, P., Troisi, R., Van Dam, Ronald, Wakabayashi, G., White, S., Halls, Mark C., Cherqui, Daniel, Taylor, Mark A., Primrose, John N., and Abu Hilal, Mohammed

Published
2018
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29. Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry

Author

Serenari M., Ratti F., Guglielmo N., Zanello M., Mocchegiani F., Lenzi J., Colledan M., Mazzaferro V., Cillo U., Ferrero A., Cescon M., Di Benedetto F., Massani M., Grazi G., Valle R. D., Vivarelli M., Ettorre G. M., Aldrighetti L., Jovine E., Serenari, M, Ratti, F, Guglielmo, N, Zanello, M, Mocchegiani, F, Lenzi, J, Colledan, M, Mazzaferro, V, Cillo, U, Ferrero, A, Cescon, M, Di Benedetto, F, Massani, M, Grazi, G, Valle, R, Vivarelli, M, Ettorre, G, Aldrighetti, L, and Jovine, E

Subjects
Hepatectomy, Laparoscopy, ALPPS, Minimally invasive, Outcome
Abstract

Background: Since 2012, Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has encountered several modifications of its original technique. The primary endpoint of this study was to analyze the trend of ALPPS in Italy over a 10-year period. The secondary endpoint was to evaluate factors affecting the risk of morbidity/mortality/post-hepatectomy liver failure (PHLF). Methods: Data of patients submitted to ALPPS between 2012 and 2021 were identified from the ALPPS Italian Registry and evaluation of time trends was performed. Results: From 2012 to 2021, a total of 268 ALPPS were performed within 17 centers. The number of ALPPS divided by the total number of liver resections performed by each center slightly declined (APC = -2.0%, p = 0.111). Minimally invasive (MI) approach significantly increased over the years (APC = + 49.5%, p = 0.002). According to multivariable analysis, MI completion of stage 1 was protective against 90-day mortality (OR = 0.05, p = 0.040) as well as enrollment within high-volume centers for liver surgery (OR = 0.32, p = 0.009). Use of interstage hepatobiliary scintigraphy (HBS) and biliary tumors were independent predictors of PHLF. Conclusions: This national study showed that use of ALPPS only slightly declined over the years with an increased use of MI techniques, leading to lower 90-day mortality. PHLF still remains an open issue.

Published
2023

30. Is minimally invasive liver surgery a reasonable option in recurrent HCC? A snapshot from the I Go MILS registry

Author

Levi Sandri, G, Colasanti, M, Aldrighetti, L, Guglielmi, A, Cillo, U, Mazzaferro, V, Dalla Valle, R, De Carlis, L, Salvatore, G, Di Benedetto, F, Ferrero, A, Ettorre, G, Antonucci, A, Batignani, G, Belli, G, Belli, A, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Cecconi, S, Colledan, M, Coratti, A, Ercolani, G, Ferla, F, Filauro, M, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Guerriero, S, Jovine, E, Magistri, P, Maida, P, Massani, M, Mezzatesta, P, Morelli, L, Russolillo, N, Navarra, G, Parisi, A, Patriti, A, Ravaioli, M, Ratti, F, Romito, R, Reggiani, P, Ruzzenente, A, Santambrogio, R, Berardi, G, Sgroi, G, Slim, A, Spada, M, Sposito, C, Tedeschi, U, Tisone, G, Torzilli, G, Veneroni, L, Vincenti, L, Zamboni, F, Zimmitti, G, Levi Sandri G. B., Colasanti M., Aldrighetti L., Guglielmi A., Cillo U., Mazzaferro V., Dalla Valle R., De Carlis L., Salvatore G., Di Benedetto F., Ferrero A., Ettorre G. M., Antonucci A., Batignani G., Belli G., Belli A., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Cecconi S., Colledan M., Coratti A., Ercolani G., Ferla F., Filauro M., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Guerriero S., Jovine E., Magistri P., Maida P., Massani M., Mezzatesta P., Morelli L., Russolillo N., Navarra G., Parisi A., Patriti A., Ravaioli M., Ratti F., Romito R., Reggiani P., Ruzzenente A., Santambrogio R., Berardi G., Sgroi G., Slim A., Spada M., Sposito C., Tedeschi U., Tisone G., Torzilli G., Veneroni L., Vincenti L., Zamboni F., Zimmitti G., Levi Sandri, G, Colasanti, M, Aldrighetti, L, Guglielmi, A, Cillo, U, Mazzaferro, V, Dalla Valle, R, De Carlis, L, Salvatore, G, Di Benedetto, F, Ferrero, A, Ettorre, G, Antonucci, A, Batignani, G, Belli, G, Belli, A, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Cecconi, S, Colledan, M, Coratti, A, Ercolani, G, Ferla, F, Filauro, M, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Guerriero, S, Jovine, E, Magistri, P, Maida, P, Massani, M, Mezzatesta, P, Morelli, L, Russolillo, N, Navarra, G, Parisi, A, Patriti, A, Ravaioli, M, Ratti, F, Romito, R, Reggiani, P, Ruzzenente, A, Santambrogio, R, Berardi, G, Sgroi, G, Slim, A, Spada, M, Sposito, C, Tedeschi, U, Tisone, G, Torzilli, G, Veneroni, L, Vincenti, L, Zamboni, F, Zimmitti, G, Levi Sandri G. B., Colasanti M., Aldrighetti L., Guglielmi A., Cillo U., Mazzaferro V., Dalla Valle R., De Carlis L., Salvatore G., Di Benedetto F., Ferrero A., Ettorre G. M., Antonucci A., Batignani G., Belli G., Belli A., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Cecconi S., Colledan M., Coratti A., Ercolani G., Ferla F., Filauro M., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Guerriero S., Jovine E., Magistri P., Maida P., Massani M., Mezzatesta P., Morelli L., Russolillo N., Navarra G., Parisi A., Patriti A., Ravaioli M., Ratti F., Romito R., Reggiani P., Ruzzenente A., Santambrogio R., Berardi G., Sgroi G., Slim A., Spada M., Sposito C., Tedeschi U., Tisone G., Torzilli G., Veneroni L., Vincenti L., Zamboni F., and Zimmitti G.

Abstract

Laparoscopic liver resection (LLR) for Hepatocellular carcinoma (HCC) is a safe procedure. Repeat surgery is more often required, and the role of minimally invasive liver surgery (MILS) is not yet clearly defined. The present study analyzes data compiled by the Italian Group of Minimally Invasive Liver Surgery (IGoMILS) on LLR. To compare repeated LLR with the first LLR for HCC is the primary endpoint. The secondary endpoint was to evaluate the outcome of repeat LLR in the case of primary open versus primary MILS surgery. The data cohort is divided into two groups. Group 1: first liver resection and Group 2: Repeat LLR. To compare the two groups a 3:1 Propensity Score Matching is performed to analyze open versus MILS primary resection. Fifty-two centers were involved in the present study, and 1054 patients were enrolled. 80 patients underwent to a repeat LLR. The type of resection was different, with more major resections in the group 1 before matching the two groups. After propensity score matching 3:1, each group consisted of 222 and 74 patients. No difference between the two groups was observed. In the subgroup analysis, in 44 patients the first resection was performed by an open approach. The other 36 patients were resected with a MILS approach. We found no difference between these two subgroups of patients. The present study in repeat MILS for HCC using the IGoMILS Registry has observed the feasibility and safety of the MILS procedure.

Published
2022

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

Author

Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., Ciulli C., Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., and Ciulli C.

Abstract

Background: We aimed to evaluate, in a large Western cohort, perioperative and long-term oncological outcomes of salvage hepatectomy (SH) for recurrent hepatocellular carcinoma (rHCC) after primary hepatectomy (PH) or locoregional treatments. Methods: Data were collected from the Hepatocarcinoma Recurrence on the Liver Study Group (He.RC.O.Le.S.) Italian Registry. After 1:1 propensity score-matched analysis (PSM), two groups were compared: the PH group (patients submitted to resection for a first HCC) and the SH group (patients resected for intrahepatic rHCC after previous HCC-related treatments). Results: 2689 patients were enrolled. PH included 2339 patients, SH 350. After PSM, 263 patients were selected in each group with major resected nodule median size, intraoperative blood loss and minimally invasive approach significantly lower in the SH group. Long-term outcomes were compared, with no difference in OS and DFS. Univariate and multivariate analyses revealed only microvascular invasion as an independent prognostic factor for OS. Conclusion: SH proved to be equivalent to PH in terms of safety, feasibility and long-term outcomes, consistent with data gathered from East Asia. In the awaiting of reliable treatment-allocating algorithms for rHCC, SH appears to be a suitable alternative in patients fit for surgery, regardless of the previous therapeutic modality implemented.

Published
2022

32. Hepatectomy for Metabolic Associated Fatty Liver Disease (MAFLD) related HCC: Propensity case-matched analysis with viral- and alcohol-related HCC

Author

Conci, S, Cipriani, F, Donadon, M, Marchitelli, I, Ardito, F, Famularo, S, Perri, P, Iaria, M, Ansaloni, L, Zanello, M, La Barba, G, Patauner, S, Pinotti, E, Molfino, S, Germani, P, Romano, M, Sciannamea, I, Ferrari, C, Manzoni, A, Troci, A, Fumagalli, L, Delvecchio, A, Floridi, A, Memeo, R, Chiarelli, M, Crespi, M, Zimmitti, G, Griseri, G, Antonucci, A, Zanus, G, Tarchi, P, Baiocchi, G, Zago, M, Frena, A, Ercolani, G, Jovine, E, Maestri, M, Valle, R, Grazi, G, Romano, F, Giuliante, F, Torzilli, G, Aldrighetti, L, Ruzzenente, A, Conci S., Cipriani F., Donadon M., Marchitelli I., Ardito F., Famularo S., Perri P., Iaria M., Ansaloni L., Zanello M., La Barba G., Patauner S., Pinotti E., Molfino S., Germani P., Romano M., Sciannamea I., Ferrari C., Manzoni A., Troci A., Fumagalli L., Delvecchio A., Floridi A., Memeo R., Chiarelli M., Crespi M., Zimmitti G., Griseri G., Antonucci A., Zanus G., Tarchi P., Baiocchi G. L., Zago M., Frena A., Ercolani G., Jovine E., Maestri M., Valle R. D., Grazi G. L., Romano F., Giuliante F., Torzilli G., Aldrighetti L., Ruzzenente A., Conci, S, Cipriani, F, Donadon, M, Marchitelli, I, Ardito, F, Famularo, S, Perri, P, Iaria, M, Ansaloni, L, Zanello, M, La Barba, G, Patauner, S, Pinotti, E, Molfino, S, Germani, P, Romano, M, Sciannamea, I, Ferrari, C, Manzoni, A, Troci, A, Fumagalli, L, Delvecchio, A, Floridi, A, Memeo, R, Chiarelli, M, Crespi, M, Zimmitti, G, Griseri, G, Antonucci, A, Zanus, G, Tarchi, P, Baiocchi, G, Zago, M, Frena, A, Ercolani, G, Jovine, E, Maestri, M, Valle, R, Grazi, G, Romano, F, Giuliante, F, Torzilli, G, Aldrighetti, L, Ruzzenente, A, Conci S., Cipriani F., Donadon M., Marchitelli I., Ardito F., Famularo S., Perri P., Iaria M., Ansaloni L., Zanello M., La Barba G., Patauner S., Pinotti E., Molfino S., Germani P., Romano M., Sciannamea I., Ferrari C., Manzoni A., Troci A., Fumagalli L., Delvecchio A., Floridi A., Memeo R., Chiarelli M., Crespi M., Zimmitti G., Griseri G., Antonucci A., Zanus G., Tarchi P., Baiocchi G. L., Zago M., Frena A., Ercolani G., Jovine E., Maestri M., Valle R. D., Grazi G. L., Romano F., Giuliante F., Torzilli G., Aldrighetti L., and Ruzzenente A.

Abstract

Background and aims: We investigated the clinical impact of the newly defined metabolic-associated fatty liver disease (MAFLD) in patients undergoing hepatectomy for HCC (MAFLD-HCC) comparing the characteristics and outcomes of patients with MAFLD-HCC to viral- and alcoholic-related HCC (HCV-HCC, HBV-HCC, A-HCC). Methods: A retrospective analysis of patients included in the He.RC.O.Le.S. Group registry was performed. The characteristics, short- and long-term outcomes of 1315 patients included were compared according to the study group before and after an exact propensity score match (PSM). Results: Among the whole study population, 264 (20.1%) had MAFLD-HCC, 205 (15.6%) had HBV-HCC, 671 (51.0%) had HCV-HCC and 175 (13.3%) had A-HCC. MAFLD-HCC patients had higher BMI (p < 0.001), Charlson Comorbidities Index (p < 0.001), size of tumour (p < 0.001), and presence of cirrhosis (p < 0.001). After PSM, the 90-day mortality and severe morbidity rates were 5.9% and 7.1% in MAFLD-HCC, 2.3% and 7.1% in HBV-HCC, 3.5% and 11.7% in HCV-HCC, and 1.2% and 8.2% in A-HCC (p = 0.061 and p = 0.447, respectively). The 5-year OS and RFS rates were 54.4% and 37.1% in MAFLD-HCC, 64.9% and 32.2% in HBV-HCC, 53.4% and 24.7% in HCV-HCC and 62.0% and 37.8% in A-HCC (p = 0.345 and p = 0.389, respectively). Cirrhosis, multiple tumours, size and satellitosis seems to be the independent predictors of OS. Conclusion: Hepatectomy for MAFLD-HCC seems to have a higher but acceptable operative risk. However, long-term outcomes seems to be related to clinical and pathological factors rather than aetiological risk factors.

Published
2022

33. Correction to: Is minimally invasive liver surgery a reasonable option in recurrent HCC? A snapshot from the I Go MILS registry (Updates in Surgery, (2021), 10.1007/s13304-021-01161-w)

Author

Levi Sandri G. B., Levi Sandri, G, Colasanti, M, Aldrighetti, L, Guglielmi, A, Cillo, U, Mazzaferro, V, Dalla Valle, R, De Carlis, L, Gruttadauria, S, Di Benedetto, F, Ferrero, A, Ettorre, G, Antonucci, A, Batignani, G, Belli, G, Belli, A, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Cecconi, S, Colledan, M, Coratti, A, Ercolani, G, Ferla, F, Filauro, M, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Guerriero, S, Jovine, E, Magistri, P, Maida, P, Massani, M, Mezzatesta, P, Morelli, L, Russolillo, N, Navarra, G, Parisi, A, Patriti, A, Ravaioli, M, Ratti, F, Romito, R, Reggiani, P, Ruzzenente, A, Santambrogio, R, Berardi, G, Sgroi, G, Slim, A, Spada, M, Sposito, C, Tedeschi, U, Tisone, G, Torzilli, G, Veneroni, L, Vincenti, L, Zamboni, F, Zimmitti, G, Levi Sandri G. B., Colasanti M., Aldrighetti L., Guglielmi A., Cillo U., Mazzaferro V., Dalla Valle R., De Carlis L., Gruttadauria S., Di Benedetto F., Ferrero A., Ettorre G. M., Antonucci A., Batignani G., Belli G., Belli A., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Cecconi S., Colledan M., Coratti A., Ercolani G., Ferla F., Filauro M., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Guerriero S., Jovine E., Magistri P., Maida P., Massani M., Mezzatesta P., Morelli L., Russolillo N., Navarra G., Parisi A., Patriti A., Ravaioli M., Ratti F., Romito R., Reggiani P., Ruzzenente A., Santambrogio R., Berardi G., Sgroi G., Slim A., Spada M., Sposito C., Tedeschi U., Tisone G., Torzilli G., Veneroni L., Vincenti L., Zamboni F., Zimmitti G., Levi Sandri G. B., Levi Sandri, G, Colasanti, M, Aldrighetti, L, Guglielmi, A, Cillo, U, Mazzaferro, V, Dalla Valle, R, De Carlis, L, Gruttadauria, S, Di Benedetto, F, Ferrero, A, Ettorre, G, Antonucci, A, Batignani, G, Belli, G, Belli, A, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Cecconi, S, Colledan, M, Coratti, A, Ercolani, G, Ferla, F, Filauro, M, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Guerriero, S, Jovine, E, Magistri, P, Maida, P, Massani, M, Mezzatesta, P, Morelli, L, Russolillo, N, Navarra, G, Parisi, A, Patriti, A, Ravaioli, M, Ratti, F, Romito, R, Reggiani, P, Ruzzenente, A, Santambrogio, R, Berardi, G, Sgroi, G, Slim, A, Spada, M, Sposito, C, Tedeschi, U, Tisone, G, Torzilli, G, Veneroni, L, Vincenti, L, Zamboni, F, Zimmitti, G, Levi Sandri G. B., Colasanti M., Aldrighetti L., Guglielmi A., Cillo U., Mazzaferro V., Dalla Valle R., De Carlis L., Gruttadauria S., Di Benedetto F., Ferrero A., Ettorre G. M., Antonucci A., Batignani G., Belli G., Belli A., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Cecconi S., Colledan M., Coratti A., Ercolani G., Ferla F., Filauro M., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Guerriero S., Jovine E., Magistri P., Maida P., Massani M., Mezzatesta P., Morelli L., Russolillo N., Navarra G., Parisi A., Patriti A., Ravaioli M., Ratti F., Romito R., Reggiani P., Ruzzenente A., Santambrogio R., Berardi G., Sgroi G., Slim A., Spada M., Sposito C., Tedeschi U., Tisone G., Torzilli G., Veneroni L., Vincenti L., Zamboni F., and Zimmitti G.

Abstract

In the originally published article the co-author first name and last name was interchanged. The correct name is copied below Salvatore Gruttadauria The original article has been updated.

Published
2022

34. Variations in risk-adjusted outcomes following 4318 laparoscopic liver resections

Author

Cucchetti, A, Aldrighetti, L, Ratti, F, Ferrero, A, Guglielmi, A, Giuliante, F, Cillo, U, Mazzaferro, V, De Carlis, L, Ercolani, G, Ettorre, G, di Benedetto, F, Valle, R, Gruttadauria, S, Jovine, E, Boggi, U, Vincenti, L, Santambrogio, R, Giuliani, A, Torzilli, G, Zimmiti, G, Brolese, A, Belli, A, Ravaioli, M, Frena, A, Rossi, G, Grazi, G, Zamboni, F, Berti, S, Calise, F, Massani, M, Morelli, L, Filauro, M, Tisone, G, Coratti, A, Navarra, G, Romito, R, Ceccarelli, G, Belli, G, Griseri, G, Antonucci, A, Mezzatesta, P, Veneroni, L, Schiavo, M, Colledan, M, Parisi, A, Guerriero, S, Spada, M, Batignani, G, Sgroi, G, Floridi, P, Boni, L, Maida, P, Ribero, D, La Barba, G, Cucchetti A., Aldrighetti L., Ratti F., Ferrero A., Guglielmi A., Giuliante F., Cillo U., Mazzaferro V., De Carlis L., Ercolani G., Ettorre G. M., di Benedetto F., Valle R. D., Gruttadauria S., Jovine E., Boggi U., Vincenti L., Santambrogio R., Giuliani A., Torzilli G., Zimmiti G., Brolese A., Belli A., Ravaioli M., Frena A., Rossi G. E., Grazi G. L., Zamboni F., Berti S., Calise F., Massani M., Morelli L., Filauro M., Tisone G., Coratti A., Navarra G., Romito R., Ceccarelli G., Belli G., Griseri G., Antonucci A., Mezzatesta P., Veneroni L., Schiavo M., Colledan M., Parisi A., Guerriero S., Spada M., Batignani G., Sgroi G., Floridi P., Boni L., Maida P., Ribero D., La Barba G., Cucchetti, A, Aldrighetti, L, Ratti, F, Ferrero, A, Guglielmi, A, Giuliante, F, Cillo, U, Mazzaferro, V, De Carlis, L, Ercolani, G, Ettorre, G, di Benedetto, F, Valle, R, Gruttadauria, S, Jovine, E, Boggi, U, Vincenti, L, Santambrogio, R, Giuliani, A, Torzilli, G, Zimmiti, G, Brolese, A, Belli, A, Ravaioli, M, Frena, A, Rossi, G, Grazi, G, Zamboni, F, Berti, S, Calise, F, Massani, M, Morelli, L, Filauro, M, Tisone, G, Coratti, A, Navarra, G, Romito, R, Ceccarelli, G, Belli, G, Griseri, G, Antonucci, A, Mezzatesta, P, Veneroni, L, Schiavo, M, Colledan, M, Parisi, A, Guerriero, S, Spada, M, Batignani, G, Sgroi, G, Floridi, P, Boni, L, Maida, P, Ribero, D, La Barba, G, Cucchetti A., Aldrighetti L., Ratti F., Ferrero A., Guglielmi A., Giuliante F., Cillo U., Mazzaferro V., De Carlis L., Ercolani G., Ettorre G. M., di Benedetto F., Valle R. D., Gruttadauria S., Jovine E., Boggi U., Vincenti L., Santambrogio R., Giuliani A., Torzilli G., Zimmiti G., Brolese A., Belli A., Ravaioli M., Frena A., Rossi G. E., Grazi G. L., Zamboni F., Berti S., Calise F., Massani M., Morelli L., Filauro M., Tisone G., Coratti A., Navarra G., Romito R., Ceccarelli G., Belli G., Griseri G., Antonucci A., Mezzatesta P., Veneroni L., Schiavo M., Colledan M., Parisi A., Guerriero S., Spada M., Batignani G., Sgroi G., Floridi P., Boni L., Maida P., Ribero D., and La Barba G.

Abstract

Background/Purpose: Quality measures in surgery are important to establish appropriate levels of care and to develop improvement strategies. The purpose of this study was to provide risk-adjusted outcome measures after laparoscopic liver resection (LLR). Methods: Data from a prospective, multicenter database involving 4318 patients submitted to LLRs in 41 hospitals from an intention-to-treat approach (2014–2020) were used to analyze heterogeneity (I2) among centers and to develop a risk-adjustment model on outcome measures through multivariable mixed-effect models to account for confounding due to case-mix. Results: Involved hospitals operated on very different patients: the largest heterogeneity was observed for operating in the presence of previous abdominal surgery (I2:79.1%), in cirrhotic patients (I2:89.3%) suffering from hepatocellular carcinoma (I2:88.6%) or requiring associated intestinal resections (I2:82.8%) and in regard to technical complexity (I2 for the most complex LLRs: 84.1%). These aspects determined substantial or large heterogeneity in overall morbidity (I2:84.9%), in prolonged in-hospital stay (I2:86.9%) and in conversion rate (I2:73.4%). Major complication had medium heterogeneity (I2:46.5%). The heterogeneity of mortality was null. Risk-adjustment accounted for all of this variability and the final risk-standardized conversion rate was 8.9%, overall morbidity was 22.1%, major morbidity was 5.1% and prolonged in-hospital stay was 26.0%. There were no outliers among the 41 participating centers. An online tool was provided. Conclusions: A benchmark for LLRs including all eligible patients was provided, suggesting that surgeons can act accordingly in the interest of the patient, modifying their approach in relation to different indications and different experience, but finally providing the same quality of care.

Published
2022

35. Pure laparoscopic versus robotic liver resections: Multicentric propensity score-based analysis with stratification according to difficulty scores

Author

Cipriani, F, Fiorentini, G, Magistri, P, Fontani, A, Menonna, F, Annecchiarico, M, Lauterio, A, De Carlis, L, Coratti, A, Boggi, U, Ceccarelli, G, Di Benedetto, F, Aldrighetti, L, Cipriani F., Fiorentini G., Magistri P., Fontani A., Menonna F., Annecchiarico M., Lauterio A., De Carlis L., Coratti A., Boggi U., Ceccarelli G., Di Benedetto F., Aldrighetti L., Cipriani, F, Fiorentini, G, Magistri, P, Fontani, A, Menonna, F, Annecchiarico, M, Lauterio, A, De Carlis, L, Coratti, A, Boggi, U, Ceccarelli, G, Di Benedetto, F, Aldrighetti, L, Cipriani F., Fiorentini G., Magistri P., Fontani A., Menonna F., Annecchiarico M., Lauterio A., De Carlis L., Coratti A., Boggi U., Ceccarelli G., Di Benedetto F., and Aldrighetti L.

Abstract

Background: The benefits of pure laparoscopic and robot-assisted liver resections (LLR and RALR) are known in comparison to open surgery. The aim of the present retrospective comparative study is to investigate the role of RALR and LLR according to different levels of difficulty. Methods: The institutional databases of six high-volume hepatobiliary centers were retrospectively reviewed. The study population was divided in two groups: LLR and RALR. The procedures were stratified for difficulty levels accordingly to three classifications. A propensity score matching was implemented to mitigate selection bias. Short-term outcomes were the object of comparison. Results: Nine hundred and thirty-six LLR and 403 RALR were collected. RALR exhibited fewer cases of intraoperative blood loss, lower transfusion and conversion rates (especially for oncological radicality) than LLR in the setting of highly difficult operations, whereas LLR had lower postoperative morbidity and fewer low-grade complications. For intermediate and low-difficulty resections, the intraoperative advantages of RALR gradually decreased to nonsignificant results and LLR remained associated with lower postoperative morbidity. Conclusion: Robot-assisted liver resections do not show operative nor clinically significant benefits over LLR for low- and intermediate-difficulty resections. By reducing conversion rates, RALR can favour the operative feasibility of difficult resections possibly extending the indications of minimally invasive approaches for liver resection.

Published
2022

36. Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

Author

Ruzzenente, A, Ciangherotti, A, Aldrighetti, L, Ettorre, G, De Carlis, L, Ferrero, A, Dalla Valle, R, Tisone, G, Guglielmi, A, Ratti, F, Gringeri, E, Russolillo, N, Campagnaro, T, Conci, S, Sandri, G, Ardito, F, Boggi, U, Gruttadauria, S, Vigano, L, Di Benedetto, F, Rossi, G, Berti, S, Ceccarelli, G, Vincenti, L, Cillo, U, Giuliante, F, Mazzaferro, V, Jovine, E, Calise, F, Belli, G, Zamboni, F, Coratti, A, Mezzatesta, P, Santambrogio, R, Navarra, G, Giuliani, A, Ferla, F, Pinna, A, Parisi, A, Colledan, M, Slim, A, Antonucci, A, Grazi, G, Frena, A, Sgroi, G, Brolese, A, Morelli, L, Floridi, A, Patriti, A, Veneroni, L, Boni, L, Maida, P, Griseri, G, Filauro, M, Guerriero, S, Romito, R, Tedeschi, U, Zimmitti, G, Ruzzenente A., Ciangherotti A., Aldrighetti L., Ettorre G. M., De Carlis L., Ferrero A., Dalla Valle R., Tisone G., Guglielmi A., Ratti F., Gringeri E., Russolillo N., Campagnaro T., Conci S., Sandri G. B. L., Ardito F., Boggi U., Gruttadauria S., Vigano L., Di Benedetto F., Rossi G. E., Berti S., Ceccarelli G., Vincenti L., Cillo U., Giuliante F., Mazzaferro V., Jovine E., Calise F., Belli G., Zamboni F., Coratti A., Mezzatesta P., Santambrogio R., Navarra G., Giuliani A., Ferla F., Pinna A. D., Parisi A., Colledan M., Slim A., Antonucci A., Grazi G. L., Frena A., Sgroi G., Brolese A., Morelli L., Floridi A., Patriti A., Veneroni L., Boni L., Maida P., Griseri G., Filauro M., Guerriero S., Romito R., Tedeschi U., Zimmitti G., Ruzzenente, A, Ciangherotti, A, Aldrighetti, L, Ettorre, G, De Carlis, L, Ferrero, A, Dalla Valle, R, Tisone, G, Guglielmi, A, Ratti, F, Gringeri, E, Russolillo, N, Campagnaro, T, Conci, S, Sandri, G, Ardito, F, Boggi, U, Gruttadauria, S, Vigano, L, Di Benedetto, F, Rossi, G, Berti, S, Ceccarelli, G, Vincenti, L, Cillo, U, Giuliante, F, Mazzaferro, V, Jovine, E, Calise, F, Belli, G, Zamboni, F, Coratti, A, Mezzatesta, P, Santambrogio, R, Navarra, G, Giuliani, A, Ferla, F, Pinna, A, Parisi, A, Colledan, M, Slim, A, Antonucci, A, Grazi, G, Frena, A, Sgroi, G, Brolese, A, Morelli, L, Floridi, A, Patriti, A, Veneroni, L, Boni, L, Maida, P, Griseri, G, Filauro, M, Guerriero, S, Romito, R, Tedeschi, U, Zimmitti, G, Ruzzenente A., Ciangherotti A., Aldrighetti L., Ettorre G. M., De Carlis L., Ferrero A., Dalla Valle R., Tisone G., Guglielmi A., Ratti F., Gringeri E., Russolillo N., Campagnaro T., Conci S., Sandri G. B. L., Ardito F., Boggi U., Gruttadauria S., Vigano L., Di Benedetto F., Rossi G. E., Berti S., Ceccarelli G., Vincenti L., Cillo U., Giuliante F., Mazzaferro V., Jovine E., Calise F., Belli G., Zamboni F., Coratti A., Mezzatesta P., Santambrogio R., Navarra G., Giuliani A., Ferla F., Pinna A. D., Parisi A., Colledan M., Slim A., Antonucci A., Grazi G. L., Frena A., Sgroi G., Brolese A., Morelli L., Floridi A., Patriti A., Veneroni L., Boni L., Maida P., Griseri G., Filauro M., Guerriero S., Romito R., Tedeschi U., and Zimmitti G.

Abstract

Background: Although isolated caudate lobe (CL) liver resection is not a contraindication for minimally invasive liver surgery (MILS), feasibility and safety of the procedure are still poorly investigated. To address this gap, we evaluate data on the Italian prospective maintained database on laparoscopic liver surgery (IgoMILS) and compare outcomes between MILS and open group. Methods: Perioperative data of patients with malignancies, as colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), non-colorectal liver metastases (NCRLM) and benign liver disease, were retrospectively analyzed. A propensity score matching (PSM) analysis was performed to balance the potential selection bias for MILS and open group. Results: A total of 224 patients were included in the study, 47 and 177 patients underwent MILS and open isolated CL resection, respectively. The overall complication rate was comparable between the two groups; however, severe complication rate (Dindo–Clavien grade ≥ 3) was lower in the MILS group (0% versus 6.8%, P = ns). In-hospital mortality was 0% in both groups and mean hospital stay was significantly shorter in the MILS group (P = 0.01). After selection of 42 MILS and 43 open CL resections by PSM analysis, intraoperative and postoperative outcomes remained similar except for the hospital stay which was not significantly shorter in MILS group. Conclusions: This multi-institutional cohort study shows that MILS CL resection is feasible and safe. The surgical procedure can be technically demanding compared to open resection, whereas good perioperative outcomes can be achieved in highly selected patients.

Published
2022

43. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., Manzoni A., Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., and Manzoni A.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

44. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author

Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)

Abstract

Background: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Methods: Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. Results: In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [4-8] vs. 6 [5-9] days, p-value = 0.043) were found in the NAT-group. Conclusion: The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM.

Published
2023

45. Survival benefit of adequate lymphadenectomy in patients undergoing liver resection for clinically node-negative intrahepatic cholangiocarcinoma

Author

Sposito, C., Ratti, F., Cucchetti, A., Ardito, Francesco, Ruzzenente, A., Di Sandro, S., Maspero, M., Ercolani, G., Di Benedetto, F., Guglielmi, A., Giuliante, Felice, Aldrighetti, L., Mazzaferro, V., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Sposito, C., Ratti, F., Cucchetti, A., Ardito, Francesco, Ruzzenente, A., Di Sandro, S., Maspero, M., Ercolani, G., Di Benedetto, F., Guglielmi, A., Giuliante, Felice, Aldrighetti, L., Mazzaferro, V., Ardito F. (ORCID:0000-0003-1596-2862), and Giuliante F. (ORCID:0000-0001-9517-8220)

Abstract

Background & Aims: Lymph-nodal status is an important predictor of survival in intrahepatic cholangiocarcinoma (iCCA), but the need to perform lymphadenectomy in patients with clinically node-negative (cN0) iCCA is still under debate. The aim of this study was to determine whether adequate lymphadenectomy improves long-term outcomes in patients undergoing liver resection for cN0 iCCA. Methods: We performed a retrospective cohort study on consecutive patients who underwent radical liver resection for cN0 iCCA at five tertiary referral centers. A propensity score based on preoperative data was calculated and used to generate stabilized inverse probability of treatment weight (IPTW). Overall and recurrence-free survival of patients undergoing adequate (≥6 retrieved lymph nodes) vs. inadequate lymphadenectomy were compared. Interactions between adequacy of lymphadenectomy and clinical variables of interest were explored through Cox IPTW regression. Results: The study includes 706 patients who underwent curative surgery for cN0 iCCA. Four-hundred and seventeen (59.1%) received adequate lymphadenectomy. After a median follow-up of 33 months (IQR 18-77), median overall survival was 39 months (IQR 23-109) and median recurrence-free survival was 23 months (IQR 8-74). After stratification according to nodal status at final pathology, node-positive patients had longer overall survival (28 vs. 23 months; hazard ratio 1.82; 95% CI 1.14-2.90; p = 0.023) and disease-free survival (13 vs. 9 months; hazard ratio 1.35; 95% CI 1.14-1.59; p = 0.008) after adequate lymphadenectomy. Adequate lymphadenectomy significantly improved survival outcomes in patients without chronic liver disease, and in patients with less-advanced tumors (solitary tumors, tumor size <5 cm, carbohydrate antigen 19-9 <200 U/ml). Conclusions: Adequate lymphadenectomy provided better survival outcomes for patients with cN0 iCCA who were found to be node-positive at pathology, supporting the routine use of

Published
2023

46. Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Author

Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)

Abstract

Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). Background: There is limited published data to date on the best achievable outcomes after L-LR. Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. Results: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. Conclusions: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.

Published
2023

47. Short and long-term outcomes after minimally invasive liver resection for single small hepatocellular carcinoma: An analysis of 714 patients from the IGoMILS (Italian group of minimally invasive liver surgery) registry

Author

Giuliante, Felice, Ratti, F., Panettieri, Elena, Mazzaferro, V., Guglielmi, A., Ettorre, G. M., Gruttadauria, S., Di Benedetto, F., Cillo, U., De Carlis, L., Dalla Valle, R., Ferrero, A., Santambrogio, R., Ardito, Francesco, Aldrighetti, L., Giuliante F. (ORCID:0000-0001-9517-8220), Panettieri E., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante, Felice, Ratti, F., Panettieri, Elena, Mazzaferro, V., Guglielmi, A., Ettorre, G. M., Gruttadauria, S., Di Benedetto, F., Cillo, U., De Carlis, L., Dalla Valle, R., Ferrero, A., Santambrogio, R., Ardito, Francesco, Aldrighetti, L., Giuliante F. (ORCID:0000-0001-9517-8220), Panettieri E., and Ardito F. (ORCID:0000-0003-1596-2862)

Abstract

Background: Widespread use of minimally invasive liver surgery (MILS) contributed to the reduction of surgical risk of liver resection for hepatocellular carcinoma (HCC). Aim of this study was to analyze outcomes of MILS for single ≤3 cm HCC. Methods: Patients who underwent MILS for single ≤3 cm HCC (November 2014 - December 2019) were identified from the Italian Group of Minimally Invasive Liver Surgery (IGoMILS) Registry. Results: Of 714 patients included, 641 (93.0%) were Child-Pugh A; 65.7% were limited resections and 2.2% major resections, with a conversion rate of 5.2%. Ninety-day mortality rate was 0.3%. Overall morbidity rate was 22.4% (3.8% major complications). Mean postoperative stay was 5 days. Robotic resection showed longer operative time (p = 0.004) and a higher overall morbidity rate (p < 0.001), with similar major complications (p = 0.431). Child-Pugh B patients showed worse mortality (p = 0.017) and overall morbidity (p = 0.021), and longer postoperative stay (p = 0.005). Five-year overall survival was 79.5%; cirrhosis, satellite micronodules, and microvascular invasion were independently associated with survival. Conclusions: MILS for ≤3 cm HCC was associated with low morbidity and mortality rates, showing high safety, and supporting the increasing indications for surgical resection in these patients.

Published
2023

48. Machine Learning Predictive Model to Guide Treatment Allocation for Recurrent Hepatocellular Carcinoma After Surgery

Author

Famularo, S., Donadon, M., Cipriani, F., Fazio, F., Ardito, Francesco, Iaria, M., Perri, P., Conci, S., Dominioni, T., Lai, Q., La Barba, G., Patauner, S., Molfino, S., Germani, P., Zimmitti, G., Pinotti, E., Zanello, M., Fumagalli, L., Ferrari, C., Romano, M., Delvecchio, A., Valsecchi, M. G., Antonucci, A., Piscaglia, F., Farinati, F., Kawaguchi, Y., Hasegawa, K., Memeo, R., Zanus, G., Griseri, G., Chiarelli, M., Jovine, E., Zago, M., Abu Hilal, M., Tarchi, P., Baiocchi, G. L., Frena, A., Ercolani, G., Rossi, M., Maestri, M., Ruzzenente, A., Grazi, G. L., Dalla Valle, R., Romano, F., Giuliante, Felice, Ferrero, A., Aldrighetti, L., Bernasconi, D. P., Torzilli, G., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Famularo, S., Donadon, M., Cipriani, F., Fazio, F., Ardito, Francesco, Iaria, M., Perri, P., Conci, S., Dominioni, T., Lai, Q., La Barba, G., Patauner, S., Molfino, S., Germani, P., Zimmitti, G., Pinotti, E., Zanello, M., Fumagalli, L., Ferrari, C., Romano, M., Delvecchio, A., Valsecchi, M. G., Antonucci, A., Piscaglia, F., Farinati, F., Kawaguchi, Y., Hasegawa, K., Memeo, R., Zanus, G., Griseri, G., Chiarelli, M., Jovine, E., Zago, M., Abu Hilal, M., Tarchi, P., Baiocchi, G. L., Frena, A., Ercolani, G., Rossi, M., Maestri, M., Ruzzenente, A., Grazi, G. L., Dalla Valle, R., Romano, F., Giuliante, Felice, Ferrero, A., Aldrighetti, L., Bernasconi, D. P., Torzilli, G., Ardito F. (ORCID:0000-0003-1596-2862), and Giuliante F. (ORCID:0000-0001-9517-8220)

Abstract

Importance: Clear indications on how to select retreatments for recurrent hepatocellular carcinoma (HCC) are still lacking. Objective: To create a machine learning predictive model of survival after HCC recurrence to allocate patients to their best potential treatment. Design, Setting, and Participants: Real-life data were obtained from an Italian registry of hepatocellular carcinoma between January 2008 and December 2019 after a median (IQR) follow-up of 27 (12-51) months. External validation was made on data derived by another Italian cohort and a Japanese cohort. Patients who experienced a recurrent HCC after a first surgical approach were included. Patients were profiled, and factors predicting survival after recurrence under different treatments that acted also as treatment effect modifiers were assessed. The model was then fitted individually to identify the best potential treatment. Analysis took place between January and April 2021. Exposures: Patients were enrolled if treated by reoperative hepatectomy or thermoablation, chemoembolization, or sorafenib. Main Outcomes and Measures: Survival after recurrence was the end point. Results: A total of 701 patients with recurrent HCC were enrolled (mean [SD] age, 71 [9] years; 151 [21.5%] female). Of those, 293 patients (41.8%) received reoperative hepatectomy or thermoablation, 188 (26.8%) received sorafenib, and 220 (31.4%) received chemoembolization. Treatment, age, cirrhosis, number, size, and lobar localization of the recurrent nodules, extrahepatic spread, and time to recurrence were all treatment effect modifiers and survival after recurrence predictors. The area under the receiver operating characteristic curve of the predictive model was 78.5% (95% CI, 71.7%-85.3%) at 5 years after recurrence. According to the model, 611 patients (87.2%) would have benefited from reoperative hepatectomy or thermoablation, 37 (5.2%) from sorafenib, and 53 (7.6%) from chemoembolization in terms of potential survival after re

Published
2023

49. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Author

Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)

Abstract

Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.

Published
2023

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