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Article: Impact of tumor size on the difficulty of laparoscopic major hepatectomies: an international multicenter study

TitleImpact of tumor size on the difficulty of laparoscopic major hepatectomies: an international multicenter study
Authors
Kato, YutaroSugioka, AtsushiKojima, MasayukiSyn, Nicholas LZhongkai, WangLiu, RongCipriani, FedericaArmstrong, ThomasAghayan, Davit LSiow, Tiing-FoongLim, ChetanaScatton, OlivierHerman, PauloCoelho, Fabricio FerreiraMarino, Marco VMazzaferro, VincenzoChiow, Adrian K HSucandy, IswantoIvanecz, ArpadChoi, Sung HoonLee, Jae HoonGastaca, MikelVivarelli, MarcoGiuliante, FeliceDalla, Valle BernardoRuzzenente, AndreaYong, Chee-ChienFondevila, ConstantinoEfanov, MikhailDi Benedetto, FabrizioBelli, AndreaPark, James ORotellar, FernandoChoi, Gi-HongRobles-Campos, RicardoWang, XiaoyingSutcliffe, Robert PSchmelzle, MoritzPratschke, JohannLai, Eric C HChong, Charing C ND’Hondt, MathieuMonden, KazuteruLopez-Ben, SantiagoKingham, T PeterForchino, FabioFerrero, AlessandroEttorre, Giuseppe MariaLevi, Sandri Giovanni BattistaPascual, FrancoCherqui, DanielSoubrane, OlivierWakabayashi, GoTroisi, Roberto ICheung, Tan-ToChen, ZeweiYin, MengqiuD’Silva, MizelleHan, Ho-SeongNghia, Phan PhuocLong, Tran Cong duyEdwin, BjørnFuks, DavidChen, Kuo-HsinAbu, Hilal MohammadAldrighetti, LucaGoh, Brian K PPrieto, Mikelde Meyere, CelineMeurs, JuulLee, Kit-FaiSalimgereeva, DianaAlikhanov, RuslanLee, Lip-SengJang, Jae YoungKruger, Jaime Arthur PirolaLopez-Lopez, VictorCasellas, I Robert MargaridaMontalti, RobertoLee, BoramWang, Hao-PingSaleh, MansourVani, SimoneArdito, FrancescoGiustizieri, UgoCitterio, DavideMocchegiani, FedericoColasanti, MarcoGuzmán, YoelimarLabadie, Kevin PMagistri, PaoloMishima, KoheiKrenzien, FelixKadam, PrashantTang, Chung NgaiGhotbi, JacobFretland, Åsmund AvdemGiglio, MarianoMazzotta, AlessandroLiu, QuYu, Shian
KeywordsDifficulty
Laparoscopic liver resection
Major hepatectomy
Minimally invasive liver
Size
Issue Date1-Oct-2023
PublisherSpringer
Citation
Annals of Surgical Oncology, 2023, v. 30, n. 11, p. 6628-6636 How to Cite?
Abstract

IntroductionAlthough tumor size (TS) is known to affect surgical outcomes in laparoscopic liver resection (LLR), its impact on laparoscopic major hepatectomy (L-MH) is not well studied. The objectives of this study were to investigate the impact of TS on the perioperative outcomes of L-MH and to elucidate the optimal TS cutoff for stratifying the difficulty of L-MH.MethodsThis was a post-hoc analysis of 3008 patients who underwent L-MH at 48 international centers. A total 1396 patients met study criteria and were included. The impact of TS cutoffs was investigated by stratifying TS at each 10-mm interval. The optimal cutoffs were determined taking into consideration the number of endpoints which showed a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors.ResultsWe identified 2 optimal TS cutoffs, 50 mm and 100 mm, which segregated L-MH into 3 groups. An increasing TS across these 3 groups (& LE; 50 mm, 51-100 mm, > 100 mm), was significantly associated with a higher open conversion rate (11.2%, 14.7%, 23.0%, P < 0.001), longer operating time (median, 340 min, 346 min, 365 min, P = 0.025), increased blood loss (median, 300 ml, ml, 400 ml, P = 0.002) and higher rate of intraoperative blood transfusion (13.1%, 15.9%, 27.6%, P < 0.001). Postoperative outcomes such as overall morbidity, major morbidity, and length of stay were comparable across the three groups.ConclusionIncreasing TS was associated with poorer intraoperative but not postoperative outcomes after L-MH. We determined 2 TS cutoffs (50 mm and 10 mm) which could optimally stratify the surgical difficulty of L-MH.


Persistent Identifierhttp://hdl.handle.net/10722/339444
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.037
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKato, Yutaro-
dc.contributor.authorSugioka, Atsushi-
dc.contributor.authorKojima, Masayuki-
dc.contributor.authorSyn, Nicholas L-
dc.contributor.authorZhongkai, Wang-
dc.contributor.authorLiu, Rong-
dc.contributor.authorCipriani, Federica-
dc.contributor.authorArmstrong, Thomas-
dc.contributor.authorAghayan, Davit L-
dc.contributor.authorSiow, Tiing-Foong-
dc.contributor.authorLim, Chetana-
dc.contributor.authorScatton, Olivier-
dc.contributor.authorHerman, Paulo-
dc.contributor.authorCoelho, Fabricio Ferreira-
dc.contributor.authorMarino, Marco V-
dc.contributor.authorMazzaferro, Vincenzo-
dc.contributor.authorChiow, Adrian K H-
dc.contributor.authorSucandy, Iswanto-
dc.contributor.authorIvanecz, Arpad-
dc.contributor.authorChoi, Sung Hoon-
dc.contributor.authorLee, Jae Hoon-
dc.contributor.authorGastaca, Mikel-
dc.contributor.authorVivarelli, Marco-
dc.contributor.authorGiuliante, Felice-
dc.contributor.authorDalla, Valle Bernardo-
dc.contributor.authorRuzzenente, Andrea-
dc.contributor.authorYong, Chee-Chien-
dc.contributor.authorFondevila, Constantino-
dc.contributor.authorEfanov, Mikhail-
dc.contributor.authorDi Benedetto, Fabrizio-
dc.contributor.authorBelli, Andrea-
dc.contributor.authorPark, James O-
dc.contributor.authorRotellar, Fernando-
dc.contributor.authorChoi, Gi-Hong-
dc.contributor.authorRobles-Campos, Ricardo-
dc.contributor.authorWang, Xiaoying-
dc.contributor.authorSutcliffe, Robert P-
dc.contributor.authorSchmelzle, Moritz-
dc.contributor.authorPratschke, Johann-
dc.contributor.authorLai, Eric C H-
dc.contributor.authorChong, Charing C N-
dc.contributor.authorD’Hondt, Mathieu-
dc.contributor.authorMonden, Kazuteru-
dc.contributor.authorLopez-Ben, Santiago-
dc.contributor.authorKingham, T Peter-
dc.contributor.authorForchino, Fabio-
dc.contributor.authorFerrero, Alessandro-
dc.contributor.authorEttorre, Giuseppe Maria-
dc.contributor.authorLevi, Sandri Giovanni Battista-
dc.contributor.authorPascual, Franco-
dc.contributor.authorCherqui, Daniel-
dc.contributor.authorSoubrane, Olivier-
dc.contributor.authorWakabayashi, Go-
dc.contributor.authorTroisi, Roberto I-
dc.contributor.authorCheung, Tan-To-
dc.contributor.authorChen, Zewei-
dc.contributor.authorYin, Mengqiu-
dc.contributor.authorD’Silva, Mizelle-
dc.contributor.authorHan, Ho-Seong-
dc.contributor.authorNghia, Phan Phuoc-
dc.contributor.authorLong, Tran Cong duy-
dc.contributor.authorEdwin, Bjørn-
dc.contributor.authorFuks, David-
dc.contributor.authorChen, Kuo-Hsin-
dc.contributor.authorAbu, Hilal Mohammad-
dc.contributor.authorAldrighetti, Luca-
dc.contributor.authorGoh, Brian K P-
dc.contributor.authorPrieto, Mikel-
dc.contributor.authorde Meyere, Celine-
dc.contributor.authorMeurs, Juul-
dc.contributor.authorLee, Kit-Fai-
dc.contributor.authorSalimgereeva, Diana-
dc.contributor.authorAlikhanov, Ruslan-
dc.contributor.authorLee, Lip-Seng-
dc.contributor.authorJang, Jae Young-
dc.contributor.authorKruger, Jaime Arthur Pirola-
dc.contributor.authorLopez-Lopez, Victor-
dc.contributor.authorCasellas, I Robert Margarida-
dc.contributor.authorMontalti, Roberto-
dc.contributor.authorLee, Boram-
dc.contributor.authorWang, Hao-Ping-
dc.contributor.authorSaleh, Mansour-
dc.contributor.authorVani, Simone-
dc.contributor.authorArdito, Francesco-
dc.contributor.authorGiustizieri, Ugo-
dc.contributor.authorCitterio, Davide-
dc.contributor.authorMocchegiani, Federico-
dc.contributor.authorColasanti, Marco-
dc.contributor.authorGuzmán, Yoelimar-
dc.contributor.authorLabadie, Kevin P-
dc.contributor.authorMagistri, Paolo-
dc.contributor.authorMishima, Kohei-
dc.contributor.authorKrenzien, Felix-
dc.contributor.authorKadam, Prashant-
dc.contributor.authorTang, Chung Ngai-
dc.contributor.authorGhotbi, Jacob-
dc.contributor.authorFretland, Åsmund Avdem-
dc.contributor.authorGiglio, Mariano-
dc.contributor.authorMazzotta, Alessandro-
dc.contributor.authorLiu, Qu-
dc.contributor.authorYu, Shian -
dc.date.accessioned2024-03-11T10:36:40Z-
dc.date.available2024-03-11T10:36:40Z-
dc.date.issued2023-10-01-
dc.identifier.citationAnnals of Surgical Oncology, 2023, v. 30, n. 11, p. 6628-6636-
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/339444-
dc.description.abstract<p>IntroductionAlthough tumor size (TS) is known to affect surgical outcomes in laparoscopic liver resection (LLR), its impact on laparoscopic major hepatectomy (L-MH) is not well studied. The objectives of this study were to investigate the impact of TS on the perioperative outcomes of L-MH and to elucidate the optimal TS cutoff for stratifying the difficulty of L-MH.MethodsThis was a post-hoc analysis of 3008 patients who underwent L-MH at 48 international centers. A total 1396 patients met study criteria and were included. The impact of TS cutoffs was investigated by stratifying TS at each 10-mm interval. The optimal cutoffs were determined taking into consideration the number of endpoints which showed a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors.ResultsWe identified 2 optimal TS cutoffs, 50 mm and 100 mm, which segregated L-MH into 3 groups. An increasing TS across these 3 groups (& LE; 50 mm, 51-100 mm, > 100 mm), was significantly associated with a higher open conversion rate (11.2%, 14.7%, 23.0%, P < 0.001), longer operating time (median, 340 min, 346 min, 365 min, P = 0.025), increased blood loss (median, 300 ml, ml, 400 ml, P = 0.002) and higher rate of intraoperative blood transfusion (13.1%, 15.9%, 27.6%, P < 0.001). Postoperative outcomes such as overall morbidity, major morbidity, and length of stay were comparable across the three groups.ConclusionIncreasing TS was associated with poorer intraoperative but not postoperative outcomes after L-MH. We determined 2 TS cutoffs (50 mm and 10 mm) which could optimally stratify the surgical difficulty of L-MH.<br></p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofAnnals of Surgical Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDifficulty-
dc.subjectLaparoscopic liver resection-
dc.subjectMajor hepatectomy-
dc.subjectMinimally invasive liver-
dc.subjectSize-
dc.titleImpact of tumor size on the difficulty of laparoscopic major hepatectomies: an international multicenter study-
dc.typeArticle-
dc.identifier.doi10.1245/s10434-023-13863-z-
dc.identifier.scopuseid_2-s2.0-85166001782-
dc.identifier.volume30-
dc.identifier.issue11-
dc.identifier.spage6628-
dc.identifier.epage6636-
dc.identifier.eissn1534-4681-
dc.identifier.isiWOS:001041647800008-
dc.identifier.issnl1068-9265-

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