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19.02.2020

Fully laparoscopic thermo-ablation of liver malignancies with or without liver resection: tumor location is an independent local recurrence risk factor

verfasst von: Geoffrey Ledoux, Koceila Amroun, Rami Rhaiem, Audrey Cagniet, Arman Aghaei, Olivier Bouche, Christine Hoeffel, Daniele Sommacale, Tullio Piardi, Reza Kianmanesh

Erschienen in: Surgical Endoscopy | Ausgabe 2/2021

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Abstract

Background

The aim of this study was to analyze risk factors of local recurrence (LR) after exclusive laparoscopic thermo-ablation (TA) with or without associated liver resection.

Methods

Between 2012 and 2017, among 385 patients who underwent 820 TA in our department, 65 (17%) patients (HCC = 11, LM = 54) had exclusive laparoscopic TA representing 112 lesions (HCC = 17, LM = 95). TA was associated with other procedures in 57% of cases (liver resection 81%). All TA were done without liver clamping. Median tumor size was 1.8 cm [ranges from 0.3 to 4.5], 18% of the lesions were larger than 3 cm in size and 11% close to major liver vessels. Tumors locations were 77.5% in right liver, 36% in S7&S8, and 46% in S7&S8&S4a.

Results

Mortality was nil and morbidity rate 15.4% including Dindo–Clavien > II grade 3%. The median follow-up was 24 months [0.77–75]. Per lesion LR rate after TA was 18% (n = 19 patients) with a mean time of 7.6 months. Among patients with LR, 18 (95%) could have been re-treated successfully (new resection = 11, re-TA = 7). Multivariate analyses revealed that tumor location in S7 alone, S7&S8 and/or S7, S8, or S4a were independent risk factors of LR after TA.

Conclusions

Exclusive laparoscopic TA is a safe and an effective tool to treat liver malignancies with or without liver resection. Other than classical risk factors, tumor location in upper segments of the liver, are independent risk factors for LR.

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Titel: Fully laparoscopic thermo-ablation of liver malignancies with or without liver resection: tumor location is an independent local recurrence risk factor
verfasst von: Geoffrey Ledoux
Koceila Amroun
Rami Rhaiem
Audrey Cagniet
Arman Aghaei
Olivier Bouche
Christine Hoeffel
Daniele Sommacale
Tullio Piardi
Reza Kianmanesh
Publikationsdatum: 19.02.2020
Verlag: Springer US
Erschienen in: Surgical Endoscopy / Ausgabe 2/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07456-0

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