Extreme liver surgery as treatment of liver tumors involving the hepatocaval confluence
Clin. transl. oncol. (Print)
; 18(11): 1131-1139, nov. 2016. ilus, tab
Article
in En
| IBECS
| ID: ibc-156879
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
Objective. Analyze the characteristics, surgical technique, morbidity and survival of patients treated with extreme liver surgery. Materials and methods. We present a series of consecutive patients with malignant liver tumors in hepatocaval confluence treated in a single center with extreme liver surgery (April 2008-March 2015). Data were collected prospectively and analyzed with SPSS 21.0. Results. 12 patients were included. 50 % were male and 50 % were female with a mean age of 59 ± 10 years old. The median of comorbidities was 7 according to the Charlson Age Comorbidity Index. The 75 % of the tumors were metastases, most of them from colorectal cancer. Most of the patients received neoadjuvant chemotherapy and in 58 % preoperative portal embolization was performed. Major hepatectomies were performed (66.7 % extended right hepatectomy, 33.3 % left extended hepatectomy). The 83.3 % of the patients needed vascular reconstruction. Postoperative morbidity was more than grade II in 50 % of the patients according to Dindo-Clavien classification. There was no intraoperative mortality. The postoperative mortality rate at 90 days was 33 % due to hepatic failure and biliary fistula. In December 2015, 33 % of the patients are still alive with a mean survival of 19 months (13-23) with an ECOG Performance Status of 0. Conclusion. Extreme liver surgery carries a high rate of morbidity and mortality that seem to increase with age and with higher tumor volumes, according to the literature. It is a therapeutic option to consider in patients with low comorbidity suffering from malignant neoplasms that involve the hepatocaval confluence, when no other treatment with curative intention can be performed (AU)
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Collection:
06-national
/
ES
Database:
IBECS
Main subject:
Neoadjuvant Therapy
/
Embolization, Therapeutic
/
Extracorporeal Circulation
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Hepatectomy
/
Liver Neoplasms
Type of study:
Observational_studies
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Clin. transl. oncol. (Print)
Year:
2016
Document type:
Article