Hepatic resection for primary and secondary liver malignancies

Heinrich, Stefan; Lang, Hauke

doi:10.1515/iss-2017-0009

Cited by 8 publications

(13 citation statements)

References 41 publications

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“…Liver cancer, also known as hepatic cancer, arises because of the abnormal growth of cells inside the liver [ 1 , 2 , 3 , 4 , 5 ]. It may originate in the liver from hepatocytes, bile duct epithelium, or mesenchymal tissue (primary) or spread to the liver from primary cancer developed elsewhere in the body (secondary) [ 6 , 7 , 8 , 9 , 10 ]. The most prevalent type of liver cancer is Hepatocellular carcinoma (HCC) or hepatoma with a median survival time of fewer than six months if untreated, and a five-year survival rate of only 5–9% from the time of diagnosis [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

An Analysis of Microwave Ablation Parameters for Treatment of Liver Tumors from the 3D-IRCADb-01 Database

Radmilović-Radjenović

Bošković

Sabo

et al. 2022

Biomedicines

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Simulation techniques are powerful tools for determining the optimal conditions necessary for microwave ablation to be efficient and safe for treating liver tumors. Owing to the complexity and computational resource consumption, most of the existing numerical models are two-dimensional axisymmetric models that emulate actual three-dimensional cancers and the surrounding tissue, which is often far from reality. Different tumor shapes and sizes require different input powers and ablation times to ensure the preservation of healthy tissues that can be determined only by the full three-dimensional simulations. This study aimed to tailor microwave ablation therapeutic conditions for complete tumor ablation with an adequate safety margin, while avoiding injury to the surrounding healthy tissue. Three-dimensional simulations were performed for a multi-slot microwave antenna immersed in two tumors obtained from the 3D-IRCADb-01 liver tumors database. The temperature dependence of the dielectric and thermal properties of healthy and tumoral liver tissues, blood perfusion, and water content are crucial for calculating the correct ablation time and, thereby, the correct ablation process. The developed three-dimensional simulation model may help practitioners in planning patient-individual procedures by determining the optimal input power and duration of the ablation process for the actual shape of the tumor. With proper input power, necrotic tissue is placed mainly in the tumor, and only a small amount of surrounding tissue is damaged.

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Section: Introductionmentioning

confidence: 99%

An Analysis of Microwave Ablation Parameters for Treatment of Liver Tumors from the 3D-IRCADb-01 Database

Radmilović-Radjenović

Bošković

Sabo

et al. 2022

Biomedicines

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“…As would be expected, patients with metastasis to the liver or the lungs were more likely to undergo metastasectomy while patients with metastasis to the bone, brain, or with multiple metastatic sites were more likely to undergo radiation therapy. The current widespread use of surgical resection as treatment for primary and secondary liver malignancies may explain the higher rates of metastasectomy in this population [16]. Inconsistent evidence is found when looking at the survival benefit of surgical resection of liver metastasis [17], a finding that contrasts with ours.…”

Section: Discussionmentioning

confidence: 75%

Metastasectomy versus radiation of secondary sites in stage IV breast cancer: Analysis from a national cancer registry

et al. 2021

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Locoregional therapy at primary or secondary sites in breast cancer may be associated with improved survival as compared to systemic therapy alone. We explored the sociodemographic and clinicopathologic factors associated with the use of radiation versus surgical resection of metastatic sites (metastasectomy) in patients with de novo stage IV breast cancer, followed by the associated overall survival. Methods: We sampled the National Cancer Database for patients with de novo stage IV breast cancer, (2010e2017) and described cohort's characteristics using univariate analyses. We identified 5 subgroups based on malignant site involvement: 1. Bone only, 2. Brain only, 3. Liver only, 4. Lung only, and 5. Metastasis involving >1 site. Kaplan-Meier modeling with log-rank testing and multivariate Cox Regression analysis were used to explore differences in overall survival between those that received radiation at secondary sites and those that underwent metastasectomy. Results: N ¼ 22,749patients were included in this analysis. Radiation (81.2%) was used more commonly than metastasectomy (28.8%). Metastasectomy was associated with better median overall survival across all 5 cohorts (p < .001), with the survival benefit being the most pronounced with lung only (OS: 56.9 months; HR 0.8, 95% CI 0.7e0.9, p ¼ .032), or liver only (OS: 41.6 months; HR: 0.9; 95% CI: 0.7e1.1, p < .001) metastasis. Conclusion: Metastasectomy in patients with de novo stage IV breast cancer may be associated with improved overall survival as compared to radiation of secondary lesions, particularly in those with only liver or lung involvement. Prospective randomized controlled trials investigating surgical resection of metastatic sites in patients with breast cancer are warranted.

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“…Intrahepatic cholangiocarcinomas infiltrate surrounding tissues due to their aggressive biology and often require extended resections, while hepatocellular carcinomas are often associated with cirrhotic livers which limit the extent of resection. 23 These challenges are generally associated with an increased risk of morbidity and mortality. 17,24,25 That there was no change in early outcomes after hepatectomy at our centre, despite the significantly increased complexity, is a testament to the benefit of a dedicated HPB unit.…”

Section: Discussionmentioning

confidence: 99%

“…Primary tumours are accepted to be more challenging to excise than secondary tumours. Intrahepatic cholangiocarcinomas infiltrate surrounding tissues due to their aggressive biology and often require extended resections, while hepatocellular carcinomas are often associated with cirrhotic livers which limit the extent of resection 23 . These challenges are generally associated with an increased risk of morbidity and mortality 17,24,25 .…”

Section: Discussionmentioning

confidence: 99%

Impact of establishing a specialized hepatobiliary unit on liver resections in a non‐specialized tertiary centre in regional Australia

Yeh

Palamuthusingam

Cameron

et al. 2021

ANZ Journal of Surgery

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Background In April 2018, a dedicated hepatobiliary unit was established in a tertiary hospital in North Queensland. Changes included the employment of a hepatobiliary‐trained surgeon, centralized referrals, and formalized multidisciplinary team meetings. This study aimed to evaluate the impact of establishing a hepatobiliary unit on outcomes after liver resection, in a regional centre where such procedures were previously performed by non‐specialist general surgeons. Methods Adult patients who underwent elective liver resection in Townsville from 2013 to 2020 were included in the study. Outcomes after liver resection were collected across two study periods – before and after the hepatobiliary unit was established. The primary end points were a before and after comparison of the 90‐day morbidity and mortality and the R1 margin rates. Results Across the two study periods, 76 and 77 patients, respectively, underwent liver resection. Rates of R1 resection, 90‐day mortality and major complications were not significantly different between the two study periods. Primary tumours (14.5% before versus 50.6% after) and cirrhosis (1.3% before versus 14.3% after) were significantly higher in the latter period, as was the median length of stay (4 days before versus 6 days after). Annual surgical volume increased by 75% in the period after 2018 compared to the 5 years preceding it. Conclusion Establishing a centralized hepatobiliary unit in a tertiary regional centre resulted in increased surgical volume and case complexity, with no change in early outcomes after liver resection. Overall, this dedicated unit improved the accessibility of a subspecialty surgical service in regional Australia.

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Hepatic resection for primary and secondary liver malignancies

Cited by 8 publications

References 41 publications

An Analysis of Microwave Ablation Parameters for Treatment of Liver Tumors from the 3D-IRCADb-01 Database

An Analysis of Microwave Ablation Parameters for Treatment of Liver Tumors from the 3D-IRCADb-01 Database

Metastasectomy versus radiation of secondary sites in stage IV breast cancer: Analysis from a national cancer registry

Impact of establishing a specialized hepatobiliary unit on liver resections in a non‐specialized tertiary centre in regional Australia

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