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

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

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

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.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaHPB
Volume2022
DOI
Stato di pubblicazionePubblicato - 2022

Keywords

  • hepatocellular carcinoma
  • long-term outcome
  • recurrence
  • liver resection

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