Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma

Giani, Alessandro; Cipriani, Francesco; Famularo, Simone; Donadon, Matteo; Bernasconi, Davide Paolo; Ardito, Francesco; Fazio, Federico; Nicolini, Daniele; Perri, Pasquale; Giuffrida, Mario; Pontarolo, Nicholas; Zanello, Matteo; Lai, Quirino; Conci, Simone; Molfino, Sarah; Germani, Paola; Pinotti, Enrico; Romano, Maurizio; Barba, Giuliano La; Ferrari, Cecilia; Patauner, Stefan; Manzoni, Alberto; Sciannamea, Ivano; Fumagalli, Luca; Troci, Albert; Ferraro, Valentina; Floridi, Antonio; Méméo, Riccardo; Crespi, Michele; Chiarelli, Marco; Antonucci, Adelmo; Zimmitti, Giuseppe; Frena, Antonio; Percivale, Andrea; Ercolani, Giorgio; Zanus, Giacomo; Zago, Mauro; Tarchi, Paola; Baiocchi, Gian Luca; Ruzzenente, Andrea; Rossi, Massimo; Jovine, Elio; Maestri, Marcello; Valle, Raffaele Dalla; Grazi, Gian Luca; Vivarelli, Marco; Ferrero, Alessandro; Giuliante, Felice; Torzilli, Guido; Aldrighetti, Luca; Gianotti, Luca; Romano, Fabrizio; Ciulli, Cristina; Braga, Marco; Ratti, Francesca; Costa, Guido; Razionale, Francesco; Russolillo, Nadia; Marinelli, Laura; Peppo, Valerio De; Cremaschi, Elena; Calabrese, Francesco; Laureiro, Zoe Larghi; Lazzari, Giovanni; Cosola, Davide; Montuori, Mauro; Salvador, Laura; Cucchetti, Alessandro; Franceschi, Angelo; Ciola, Michele; Sega, Valentina; Calcagno, Pietro; Pennacchi, Luca; Tedeschi, Michèle

doi:10.3390/cancers12123868

Cited by 19 publications

(15 citation statements)

References 32 publications

(50 reference statements)

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“…In a recent study the 90-d mortality in Child-Pugh B patients was 10% in cases of major hepatectomies and 3% in segmentectomies[ 70 ]. However, it should be remembered that the frequency of adverse events in hepatic surgery still remains significant[ 71 ]. A systemic review reported a postoperative complication rate ranging from 27% to 32% and mortality rate from 2.7% to 7.3% after LR among Child-Pugh A and B patients[ 45 ].…”

Section: Liver Resection In Child-pugh B Cirrhosis Patientsmentioning

confidence: 99%

Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?

Romano¹,

Chiarelli²,

Garancini³

et al. 2021

WJG

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According to Barcelona Clinic Liver Cancer recommendations, intermediate stage hepatocellular carcinomas (stage B) are excluded from liver resection and are referred to palliative treatment. Moreover, Child-Pugh B patients are not usually candidates for liver resection. However, many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection, maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver function. Several studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification, and this treatment gives good results in the setting of multinodular, large tumors in patients with portal hypertension and/or Child-Pugh B cirrhosis. In this review we explore this controversial topic, and we show through the literature analysis how liver resection may improve the short- and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma patients. However, other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection.

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Section: Liver Resection In Child-pugh B Cirrhosis Patientsmentioning

confidence: 99%

Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?

Romano¹,

Chiarelli²,

Garancini³

et al. 2021

WJG

Self Cite

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“…We investigated the expression of MCT4, a prognostic biomarker of glioblastoma aggression [ 12 , 30 ]. Using CHARTS, we found that MCT4 tended to be expressed in the myeloid tumor-infiltrating immune cells.…”

Section: Resultsmentioning

confidence: 99%

CHARTS: a web application for characterizing and comparing tumor subpopulations in publicly available single-cell RNA-seq data sets

Bernstein

Collins

et al. 2021

BMC Bioinformatics

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Background Single-cell RNA-seq (scRNA-seq) enables the profiling of genome-wide gene expression at the single-cell level and in so doing facilitates insight into and information about cellular heterogeneity within a tissue. This is especially important in cancer, where tumor and tumor microenvironment heterogeneity directly impact development, maintenance, and progression of disease. While publicly available scRNA-seq cancer data sets offer unprecedented opportunity to better understand the mechanisms underlying tumor progression, metastasis, drug resistance, and immune evasion, much of the available information has been underutilized, in part, due to the lack of tools available for aggregating and analysing these data. Results We present CHARacterizing Tumor Subpopulations (CHARTS), a web application for exploring publicly available scRNA-seq cancer data sets in the NCBI’s Gene Expression Omnibus. More specifically, CHARTS enables the exploration of individual gene expression, cell type, malignancy-status, differentially expressed genes, and gene set enrichment results in subpopulations of cells across tumors and data sets. Along with the web application, we also make available the backend computational pipeline that was used to produce the analyses that are available for exploration in the web application. Conclusion CHARTS is an easy to use, comprehensive platform for exploring single-cell subpopulations within tumors across the ever-growing collection of public scRNA-seq cancer data sets. CHARTS is freely available at charts.morgridge.org.

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“…CD classification includes only the most serious complications; conversely, the CCI score summarizes the total postoperative complication rate associated with a surgical procedure even when multiple complications occur [ 39 ]. The CCI score is considered to be more sensitive than the CD classification when reporting postoperative morbidity in liver surgery [ 40 ]. Based on the CCI score, the severity of total complications in the monopolar group was significantly higher than that in the bipolar group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

et al. 2022

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Background Various hemostatic devices have been utilized to reduce blood loss during hepatectomy. Nonetheless, a comparison between monopolar and bipolar coagulation, particularly their usefulness or inferiority, has been poorly documented. The aim of this study is to reveal the characteristics of these hemostatic devices. Methods A total of 264 patients who underwent open hepatectomy at our institution from January 2009 to December 2018 were included. Monopolar and bipolar hemostatic devices were used in 160 (monopolar group) and 104 (bipolar group) cases, respectively. Operative outcomes and thermal damage to the resected specimens were compared between these groups using propensity score matching according to background factors. Multivariate logistic regression analysis was performed to identify predictive factors for postoperative complications. Results After propensity score matching, 73 patients per group were enrolled. The monopolar group had significantly lower total operative time (239 vs. 275 min; P = 0.013) and intraoperative blood loss (487 vs. 790 mL; P < 0.001). However, the incidence rates of ascites (27.4% vs. 8.2%; P = 0.002) and grade ≥ 3 intra-abdominal infection (12.3% vs. 2.7%; P = 0.028) were significantly higher in the monopolar group. Thermal damage to the resected specimens was significantly longer in the monopolar group (4.6 vs. 1.2 mm; P < 0.001). Use of monopolar hemostatic device was an independent risk factor for ascites (odds ratio, 5.626, 95% confidence interval 1.881–16.827; P = 0.002) and severe intra-abdominal infection (odds ratio, 5.905, 95% confidence interval 1.096–31.825; P = 0.039). Conclusions Although monopolar devices have an excellent hemostatic ability, they might damage the remnant liver. The use of monopolar devices can be one of the factors that increase the frequency of complications.

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Performance of Comprehensive Complication Index and Clavien-Dindo Complication Scoring System in Liver Surgery for Hepatocellular Carcinoma

Cited by 19 publications

References 32 publications

Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?

Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?

CHARTS: a web application for characterizing and comparing tumor subpopulations in publicly available single-cell RNA-seq data sets

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

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