The role of resection in hepatocellular carcinoma BCLC stage B : A multi-institutional patient-level meta-analysis and systematic review
Lopez-Lopez, Victor (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Kalt, Fabian (University Hospital Zurich (Suïssa))
Zhong, Jian-Hong (Guangxi Medical University Cancer Hospital (Nanning, Xina))
Guidetti, Cristiano (University of Modena and Reggio Emilia)
Magistri, Paolo (University of Modena and Reggio Emilia)
Di Benedetto, Fabrizio (University of Modena and Reggio Emilia)
Weinmann, Arndt (University Medical Center of the Johannes Gutenberg University Mainz)
Mittler, Jens (Johannes Gutenberg-University Mainz)
Lang, Hauke (Johannes Gutenberg-University Mainz)
Sharma, Rohini (Imperial College London)
Vithayathil Mathew, J. (Imperial College London)
Tariq, Samir (Imperial College London)
Sánchez-Velázquez, Patricia (Hospital del Mar (Barcelona, Catalunya))
Rompianesi, Gianluca (Federico II University (Napòls, Itàlia))
Troisi, Roberto Ivan (Federico II University (Napòls, Itàlia))
Gómez Gavara, Concepción (Hospital Universitari Vall d'Hebron)
Dalmau, Mar (Hospital Universitari Vall d'Hebron)
Sanchez-Romero, Francisco Jose (University Hospital Zurich (Suïssa))
Llamoza, Camilo (University Hospital Zurich (Suïssa))
Tschuor, Christoph (Rigshospitalet Copenhagen University Hospital)
Deniz, Uluk (Heidelberg University Hospital (Alemanya))
Lurje, Georg (Heidelberg University Hospital (Alemanya))
Husen, Peri (Heidelberg University Hospital (Alemanya))
Hügli, Sandro (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Jonas, Jan Philipp (University Hospital Zurich (Suïssa))
Rössler, Fabian (University Hospital Zurich (Suïssa))
Kron, Philipp (University Hospital Zurich (Suïssa))
Ramser, Michaela (University Hospital Zurich (Suïssa))
Ramirez, Pablo (University Hospital Zurich (Suïssa))
Lehmann, Kuno (University Hospital Zurich (Suïssa))
Robles-Campos, Ricardo (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Eshmuminov, Dilmurodjon (University Hospital Zurich (Suïssa))

Fecha:	2024
Resumen:	The Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. This systematic review includes a multi-institutional meta-analysis of patient-level data. Survival, postoperative mortality, morbidity and patient selection criteria for liver resection and transplantation in BCLC stage B are explored. All clinical studies reporting HCC patients with BCLC stage B undergoing liver resection or transplantation were included. A total of 31 studies with 3163 patients were included. Patient level data was available for 580 patients from 9 studies (423 after resection and 157 after transplantation). The overall survival following resection was 50 months and recurrence-free survival was 15 months. Overall survival after transplantation was not reached and recurrence-free survival was 45 months. The major complication rate after resection was 0. 11 (95%-CI, 0. 0-0. 17) with the 90-day mortality rate of 0. 03 (95%-CI, 0. 03-0. 08). Child-Pugh A (93%), minor resection (60%), alpha protein level less than 400 (64%) were common in resected patients. Resected patients were mostly outside the Milan criteria (99%) with mean tumour number of 2. 9. Studies reporting liver transplantation in BCLC stage B were scarce. Liver resection can be performed safely in selected patients with HCC BCLC stage B, particularly if patients present with preserved liver function. No conclusion can done on liver transplantation due to scarcity of reported studies. The online version contains supplementary material available at 10. 1007/s00423-024-03466-x.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	HCC ; BCLC-B ; Liver resection ; Liver transplantation
Publicado en:	Langenbeck's archives of surgery, Vol. 409 (september 2024) , ISSN 1435-2451

DOI: 10.1007/s00423-024-03466-x
PMID: 39269544

10 p, 1.4 MB

El registro aparece en las colecciones:
Artículos > Artículos de investigación
Artículos > Artículos publicados