Novel Benchmark Values for Open Major Anatomic Liver Resection in Non-cirrhotic Patients: A Multicentric Study of 44 International Expert Centers.

Autor:	Sousa Da Silva RX; Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Breuer E; Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Shankar S; Department of Hepatobiliary and Pancreatic Surgery, King's College Hospital, London, UK., Kawakatsu S; Division of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Hołówko W; Department of General, Transplant and Liver Surgery, Medical University Warsaw, Warsaw, Poland., Santos Coelho J; Hepato-Biliary-Pancreatic and Transplantation Centre, Curry Cabral Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal., Jeddou H; Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, Rennes, France., Sugiura T; Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan., Ghallab M; Paul Brousse Hospital, AP-HP, University Paris-Saclay, Villejuif, France., Da Silva D; Department of HPB Surgery and Liver Transplantation, AP-HP Beaujon Hospital, University of Paris Cité, Clichy, France., Watanabe G; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Botea F; Department of Surgery and Transplantation, Fundeni Clinical Institute, Bucharest, Romania., Sakai N; Department of General Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan., Addeo P; Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospital, Strasbourg University, Strasbourg, France., Tzedakis S; Department of Hepatobiliary, Digestive and Endocrine Surgery, Cochin Hospital, Paris Cité University, Paris, France., Bartsch F; Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany., Balcer K; Department of Digestive Surgery and Transplantation, CHU Lille, University Lille, Lille, France., Lim C; Department of Digestive, Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière, Sorbonne Université, Centre de Recherche de Saint-Antoine, Paris, France., Werey F; Department of Oncology and Digestive Surgery, CHU Amiens-Picardie, Amiens, France., Lopez-Lopez V; Clinic and University Virgen de la Arrixaca Hospital, IMIB, Murcia, Spain., Peralta Montero L; Hepato-Pancreato-Biliary Surgery Section and Liver Transplant Unit, General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Sanchez Claria R; Hepato-Pancreato-Biliary Surgery Section and Liver Transplant Unit, General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Leiting J; Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN., Vachharajani N; Department of Surgery, Section of Abdominal Organ Transplant, Washington University School of Medicine, St Louis, MO., Hopping E; Hepatobiliary Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide & Hepatobiliary Unit, Department of Surgery, Flinders Medical Centre, Adelaide, Australia., Torres OJM; Department of Gastrointestinal Surgery, Hepatopancreatobiliary Unit, Presidente Dutra Hospital, São Luiz, Brazil., Hirano S; Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Hokkaido, Japan., Andel D; Department of Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands., Hagendoorn J; Department of Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands., Psica A; Department of Transplantation and Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Ravaioli M; Hepato-biliary surgery and Transplant Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Ahn KS; Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, School of Medicine, Keimyung University, Dongsan Hospital, Daegu, Republic of Korea., Reese T; Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Asklepios Hospital Barmbek, Semmelweis University of Medicine, Asklepios Campus Hamburg, Hamburg, Germany., Montes LA; General Surgery Department Liver, Pancreas and Intestinal Transplant Unit, Favaloro Foundation University Hospital, Buenos Aires, Argentina., Gunasekaran G; Department of Surgery, Division of HPB Service, Icahn School of Medicine at Mount Sinai, New York, NY., Alcázar C; Department of Surgery, HPB and Transplant Unit, General Universitary Hospital Alicante and Health and Biomedical Research Institute of Alicante, Alicante, Spain., Lim JH; Department of Surgery, Division of HBP Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea., Haroon M; Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan., Lu Q; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Castaldi A; Department of Digestive Surgery and Liver Transplant Unit, University Côte d'Azur, CHU de Nice, Nice, France., Orimo T; Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Hokkaido, Japan., Moeckli B; Division of Abdominal and Transplantation Surgery, University Hospitals of Geneva, Geneva, Switzerland., Abadía T; HPB Surgical Division, Miguel Servet University Hospital, Zaragoza, Spain., Ruffolo L; Department of HPB and Transplant Surgery, University of Rochester, Rochester, NY., Dib Hasan J; Transplant Unit, Hospital Aleman de Buenos Aires, Buenos Aires, Argentina., Ratti F; Division of Hepatobiliary Surgery, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy., Kauffmann EF; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy., de Wilde RF; Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands., Polak WG; Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands., Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy., Aldrighetti L; Division of Hepatobiliary Surgery, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy., McCormack L; Transplant Unit, Hospital Aleman de Buenos Aires, Buenos Aires, Argentina., Hernandez-Alejandro R; Department of HPB and Transplant Surgery, University of Rochester, Rochester, NY., Serrablo A; HPB Surgical Division, Miguel Servet University Hospital, Zaragoza, Spain., Toso C; Division of Abdominal and Transplantation Surgery, University Hospitals of Geneva, Geneva, Switzerland., Taketomi A; Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Hokkaido, Japan., Gugenheim J; Department of Digestive Surgery and Liver Transplant Unit, University Côte d'Azur, CHU de Nice, Nice, France., Dong J; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Hanif F; Department of HPB and Liver Transplant, Bahria International Hospital Orchard, Lahore, Pakistan., Park JS; Department of Surgery, Division of HBP Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea., Ramia JM; Department of Surgery, HPB and Transplant Unit, General Universitary Hospital Alicante and Health and Biomedical Research Institute of Alicante, Alicante, Spain., Schwartz M; Department of Surgery, Division of HPB Service, Icahn School of Medicine at Mount Sinai, New York, NY., Ramisch D; General Surgery Department Liver, Pancreas and Intestinal Transplant Unit, Favaloro Foundation University Hospital, Buenos Aires, Argentina., De Oliveira ML; Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Oldhafer KJ; Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Asklepios Hospital Barmbek, Semmelweis University of Medicine, Asklepios Campus Hamburg, Hamburg, Germany., Kang KJ; Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, School of Medicine, Keimyung University, Dongsan Hospital, Daegu, Republic of Korea., Cescon M; Hepato-biliary surgery and Transplant Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Lodge P; Department of Transplantation and Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Rinkes IHMB; Department of Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands., Noji T; Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Hokkaido, Japan., Thomson JE; Hepatobiliary Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide & Hepatobiliary Unit, Department of Surgery, Flinders Medical Centre, Adelaide, Australia., Goh SK; Hepatobiliary Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide & Hepatobiliary Unit, Department of Surgery, Flinders Medical Centre, Adelaide, Australia., Chapman WC; Department of Surgery, Section of Abdominal Organ Transplant, Washington University School of Medicine, St Louis, MO., Cleary SP; Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN., Pekolj J; Hepato-Pancreato-Biliary Surgery Section and Liver Transplant Unit, General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Regimbeau JM; Department of Oncology and Digestive Surgery, CHU Amiens-Picardie, Amiens, France., Scatton O; Department of Digestive, Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière, Sorbonne Université, Centre de Recherche de Saint-Antoine, Paris, France., Truant S; Department of Digestive Surgery and Transplantation, CHU Lille, University Lille, Lille, France., Lang H; Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany., Fuks D; Department of Hepatobiliary, Digestive and Endocrine Surgery, Cochin Hospital, Paris Cité University, Paris, France., Bachellier P; Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospital, Strasbourg University, Strasbourg, France., Ohtsuka M; Department of General Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan., Popescu I; Department of Surgery and Transplantation, Fundeni Clinical Institute, Bucharest, Romania., Hasegawa K; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Lesurtel M; Department of HPB Surgery and Liver Transplantation, AP-HP Beaujon Hospital, University of Paris Cité, Clichy, France., Adam R; Paul Brousse Hospital, AP-HP, University Paris-Saclay, Villejuif, France., Cherqui D; Paul Brousse Hospital, AP-HP, University Paris-Saclay, Villejuif, France., Uesaka K; Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan., Boudjema K; Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, Rennes, France., Pinto-Marques H; Hepato-Biliary-Pancreatic and Transplantation Centre, Curry Cabral Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal., Grąt M; Department of General, Transplant and Liver Surgery, Medical University Warsaw, Warsaw, Poland., Petrowsky H; Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Ebata T; Division of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Prachalias A; Department of Hepatobiliary and Pancreatic Surgery, King's College Hospital, London, UK., Robles-Campos R; Clinic and University Virgen de la Arrixaca Hospital, IMIB, Murcia, Spain., Clavien PA; Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Nov 01; Vol. 278 (5), pp. 748-755. Date of Electronic Publication: 2023 Jul 19.
DOI:	10.1097/SLA.0000000000006012
Abstrakt:	Objective: This study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities. Background: Outcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive procedures. Methods: A standard benchmark methodology was used covering consecutive patients, who underwent open major anatomic hepatectomy from 44 high-volume liver centers from 5 continents over a 5-year period (2016-2020). Benchmark cases were low-risk non-cirrhotic patients without significant comorbidities treated in high-volume centers (≥30 major liver resections/year). Benchmark values were set at the 75th percentile of median values of all centers. Minimum follow-up period was 1 year in each patient. Results: Of 8044 patients, 2908 (36%) qualified as benchmark (low-risk) cases. Benchmark cutoffs for all indications include R0 resection ≥78%; liver failure (grade B/C) ≤10%; bile leak (grade B/C) ≤18%; complications ≥grade 3 and CCI ® ≤46% and ≤9 at 3 months, respectively. Benchmark values differed significantly between malignant and benign conditions so that reference values must be adjusted accordingly. Extended right hepatectomy (H1, 4-8 or H4-8) disclosed a higher cutoff for liver failure, while extended left (H1-5,8 or H2-5,8) were associated with higher cutoffs for bile leaks, but had superior oncologic outcomes, when compared to formal left hepatectomy (H1-4 or H2-4). The minimal follow-up for a conclusive outcome evaluation following open anatomic major resection must be 3 months. Conclusion: These new benchmark cutoffs for open major hepatectomy provide a powerful tool to convincingly evaluate other approaches including parenchymal-sparing procedures, laparoscopic/robotic approaches, and alternative treatments, such as ablation therapy, irradiation, or novel chemotherapy regimens. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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