The impact of additional margin coagulation with radiofrequency in liver resections with subcentimetric margin : can we improve the oncological results? A propensity score matching study
Villamonte, María (Hospital del Mar (Barcelona, Catalunya))
Burdío, Fernando (Institut Hospital del Mar d'Investigacions Mèdiques)
Pueyo, Eva (Hospital del Mar (Barcelona, Catalunya))
Andaluz Martínez, Anna (Universitat Autònoma de Barcelona. Departament de Medicina i Cirurgia Animals)
Moll, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina i Cirurgia Animals)
Berjano, Enrique (Universitat Politècnica de València)
Radosevic, Aleksander (Hospital del Mar (Barcelona, Catalunya))
Grande, L (Hospital del Mar (Barcelona, Catalunya))
Pera, Miguel (Hospital del Mar (Barcelona, Catalunya))
Ielpo, Benedetto (Hospital del Mar (Barcelona, Catalunya))
Sánchez-Velázquez, Patricia (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2022
Descripció:	7 pàg.
Resum:	Background: Whereas the usefulness of radiofrequency (RF) energy as haemostatic method in liver surgery has become well established in the last decades, its intentional application on resection margins with the aim of reducing local recurrence is still debatable. Our goal was to compare the impact of an additional application of RF energy on the top of the resection surface, namely additional margin coagulation (AMC), on local recurrence (LR) when subjected to a subcentimeter margin. Methods: We retrospectively analyzed 185 patients out of a whole cohort of 283 patients who underwent radical hepatic resection with subcentimetric margin. After propensity score adjustment, patients were classified into two balanced groups according to whether RF was applied or not. Results: No significant differences were observed within groups in baseline characteristics after PSM adjustment. The LR rate was significantly higher in the Control than AMC Group: 12 patients (14. 5%) vs. 4 patients (4. 8%) (p = 0. 039). The estimated 1, 3, and 5-year LR-free survival rates of patients in the Control and AMC Group were: 93. 5%, 86. 0%, 81. 0% and 98. 8%, 97. 2%, 91. 9%, respectively (p = 0. 049). Univariate Cox analyses indicated that the use of the RF applicator was significantly associated with lower LR (HR = 0. 29, 95% confidence interval 0. 093-0. 906, p = 0. 033). The Control Group showed smaller coagulation widths than the AMC group (p < 0. 001). Conclusions: An additional application of RF on the top of the resection surface is associated with less local hepatic recurrence than the use of conventional techniques.
Ajuts:	Agencia Estatal de Investigación RTI2018-094357-B-C21 Agencia Estatal de Investigación RTI2018-094357-B-C22
Drets:	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.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Liver Recurrence ; Margin invasion ; Radiofrequency ablation
Publicat a:	European Journal of Surgical Oncology, Vol. 48, Núm. 1 (January 2022) , p. 82-88, ISSN 1532-2157

DOI: 10.1016/j.ejso.2021.06.008
PMID: 34148824

7 p, 694.8 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats