AI Article Synopsis
- The study examined factors influencing local recurrence of liver tumors after laparoscopic thermo-ablation (TA), with a focus on patients undergoing the procedure between 2012 and 2017.
- Among 385 patients, 65 experienced exclusive laparoscopic TA for various tumors, 57% of which had additional procedures like liver resection; they reported a low mortality rate and a 15.4% morbidity rate.
- Results showed an 18% rate of local recurrence after a median follow-up of 24 months, highlighting tumor location in specific liver segments as a significant risk factor for recurrence.
Article 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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| http://dx.doi.org/10.1007/s00464-020-07456-0 | DOI Listing |
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