Robotic Liver Resection Versus Percutaneous Ablation for Early HCC: Short- and Long-Term Results
Abstract
:Simple Summary
Abstract
1. Background
2. Results
2.1. Patient and HCC Characteristics
2.2. Procedure Characteristics
2.3. Short-Term Outcomes
2.4. HCC Recurrence and Survival
3. Discussion
4. Material and Methods
4.1. Study Design
4.2. Variables and Definitions
4.3. Statistical Analysis
4.4. Robotic Liver Resection
4.5. Percutaneous Ablation
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
Disclaimers
References
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Variable | Level | PA (N = 36) | RLR (N = 24) | p-Value 1 |
---|---|---|---|---|
Age (years), median (min–max) | 67 (20–87) | 64 (48–79) | 0.52 | |
Age (years), N (%) | <75 | 25 (69) | 21 (88) | 0.13 |
≥75 | 11 (31) | 3 (13) | ||
Sex, N (%) | Male | 26 (72) | 16 (67) | 0.78 |
Female | 10 (28) | 8 (33) | ||
BMI (Kg/m2), median (min–max) | 28.12 (17.82–38.20) | 27.25 (19.82–33.03) | 0.67 | |
BMI (Kg/m2), N (%) | Underweight | 1 (4) | 0 (0) | 0.90 |
Normal | 6 (26) | 7 (29) | ||
Overweight | 8 (35) | 10 (42) | ||
Obese | 8 (35) | 7 (29) | ||
Missing | 13 | 0 | ||
ASA, N (%) | I | 4 (11) | 0 (0) | 0.13 |
II | 10 (28) | 11 (46) | ||
III | 22 (61) | 13 (54) | ||
CCI score, median (min–max) | 7 (2–10) | 7 (3–9) | 0.62 | |
Previous abdominal surgeries, N (%) | No | 19 (53) | 14 (58) | 0.79 |
Yes | 17 (47) | 10 (42) | ||
Hypertension, N (%) | No | 20 (56) | 8 (33) | 0.12 |
Yes | 16 (44) | 16 (67) | ||
Diabetes, N (%) | No | 28 (78) | 20 (83) | 0.75 |
Yes | 8 (22) | 4 (17) | ||
Renal failure, N (%) | No | 36 (100) | 22 (92) | 0.16 |
Yes | 0 (0) | 2 (8) | ||
Liver cirrhosis, N (%) | No | 15 (42) | 6 (25) | 0.27 |
Yes | 21 (58) | 18 (75) | ||
Respiratory insufficiency, N (%) | No | 34 (94) | 23 (96) | 1.00 |
Yes | 2 (6) | 1 (4) | ||
Cardiovascular disease, N (%) | No | 29 (81) | 21 (88) | 0.73 |
Yes | 7 (19) | 3 (13) | ||
Hepatopathy, N (%) | HCV | 20 (56) | 12 (50) | 0.60 |
HBV | 8 (22) | 6 (25) | ||
Alcohol | 3 (8) | 2 (8) | ||
NASH | 4 (11) | 1 (4) | ||
HCV+HBV | 1 (3) | 1 (4) | ||
CBP | 0 (0) | 2 (8) | ||
HIV coinfection, N (%) | No | 35 (97) | 21 (88) | 0.29 |
Yes | 1 (3) | 3 (13) |
Variable | Level | PA (N = 36) | RLR (N = 24) | p-Value 1 |
---|---|---|---|---|
Ishak fibrosis score, N (%) | F0 (none to moderate fibrosis) | 14 (39) | 6 (25) | 0.40 |
F1 (severe fibrosis or cirrhosis) | 22 (61) | 18 (75) | ||
Portal hypertension, N (%) | No | 13 (36) | 10 (42) | 0.79 |
Yes | 23 (64) | 14 (58) | ||
Esophageal varices, N (%) | No | 14 (39) | 13 (54) | 0.30 |
Yes | 22 (61) | 11 (46) | ||
PLT (migl/mmc), N (%) | <100.000 | 22 (61) | 9 (38) | 0.11 |
≥100.000 | 14 (39) | 15 (63) | ||
Bilirubin (mg/dl), N (%) | ≤1 | 17 (47) | 19 (79) | 0.017 |
>1 | 19 (53) | 5 (21) | ||
Creatinine (mg/dl), N (%) | ≤1.4 | 36 (100) | 23 (96) | 0.40 |
>1.4 | 0 (0) | 1 (4) | ||
Albumin (g/dl), N (%) | <3.5 | 10 (28) | 4 (17) | 0.37 |
≥3.5 | 26 (72) | 20 (83) | ||
INR, N (%) | ≤1.25 | 19 (53) | 18 (75) | 0.11 |
>1.25 | 17 (47) | 6 (25) | ||
AFP (ng/mL.), median (min–max) | 6.1 (1.5–497.9) | 4.3 (1.2–1063.0) | 0.34 | |
MELD score, median (min–max) | 9 (6–18) | 9 (6–17) | 0.38 | |
CTP score, N (%) | A | 28 (78) | 19 (79) | 1.00 |
B | 7 (19) | 5 (21) | ||
C | 1 (3) | 0 (0) | ||
ALBI score, N (%) | 1 | 9 (25) | 15 (63) | 0.012 |
2 | 21 (58) | 8 (33) | ||
3 | 6 (17) | 1 (4) | ||
Tumor size (mm), median (min-max) | 19.5 (12.0–30.0) | 20.0 (10.0–30.0) | 0.35 | |
Tumor size (mm), N (%) | ≤20 | 24 (67) | 13 (54) | 0.42 |
>20 | 12 (33) | 11 (46) | ||
Subcapsular HCC, N (%) | No | 20 (56) | 6 (25) | 0.033 |
Yes | 16 (44) | 18 (75) | ||
Tumor location, N (%) | S1 | 2 (6) | 0 (0) | 0.25 2 |
S2 | 1 (3) | 3 (13) | ||
S3 | 2 (6) | 3 (13) | ||
S4 | 6 (17) | 4 (17) | ||
S5 | 7 (19) | 3 (13) | ||
S6 | 8 (22) | 7 (29) | ||
S7 | 4 (11) | 1 (4) | ||
S8 | 6 (17) | 3 (13) | ||
BCLC, N (%) | Stage 0 | 14 (39) | 8 (33) | 0.79 |
Stage A | 22 (61) | 16 (67) |
Variable | Level | PA (N = 36) | RLR (N = 24) | p-Value 1 |
---|---|---|---|---|
In-hospital stay (days), median (min–max) | 2 (1–6) | 4 (1–18) | <0.001 | |
Max bilirubin (mg/dL), median (min–max) | 1.45 (0.33–9.88) | 1.41 (0.52–9.17) | 0.59 | |
Max INR, median (min–max) | 1.29 (0.77–1.92) | 1.35 (1.07–2.11) | 0.12 | |
Max creatinine (mg/dL), median (min–max) | 0.86 (0.59–1.29) | 0.79 (0.52–2.32) | 0.37 | |
Morbidity, N (%) 2 3 | Clavien 0 | 29 (81) | 15 (63) | 0.15 |
Clavien > 0 | 7 (19) | 9 (38) | ||
Clavien 0 | 29 (81) | 15 (63) | 0.34 | |
Clavien I–II | 6 (17) | 8 (33) | ||
Clavien III–IV | 1 (3) | 1 (4) | ||
Liver failure, N (%) | No | 36 (100) | 23 (96) | 0.40 |
Yes | 0 (0) | 1 (4) | ||
Readmission within 30 days, N (%) | No | 34 (94) | 23 (96) | 1.00 |
Yes | 2 (6) | 1 (4) |
Variable | Level | PA (N = 36) | Segmentectomy (N = 8) | Wedge (N = 16) |
---|---|---|---|---|
In-hospital stay (days), median (min–max) | 2 (1–6) | 4 (1–5) | 4 (2–18) | |
Max bilirubin (mg/dL), median (min–max) | 1.45 (0.33–9.88) | 1.97 (0.74–4.69) | 1.38 (0.52–9.17) | |
Max INR, median (min–max) | 1.29 (0.77–1.92) | 1.29 (1.07–1.77) | 1.36 (1.14–2.11) | |
Max creatinine (mg/dL), median (min–max) | 0.86 (0.59–1.29) | 0.87 (0.59–1.25) | 0.76 (0.52–2.32) | |
Morbidity, N (%) | Clavien 0 | 29 (81) | 6 (75) | 9 (56) |
Clavien > 0 | 7 (19) | 2 (25) | 7 (44) | |
Clavien 0 | 29 (81) | 6 (75) | 9 (56) | |
Clavien I and II | 6 (17) | 2 (25) | 6 (38) | |
Clavien III and IV | 1 (3) | 0 (0) | 1 (6) | |
Liver failure, N (%) | No | 36 (100) | 8 (100) | 15 (94) |
Yes | 0 (0) | 0 (0) | 1 (6) | |
Readmission within 30 days, N (%) | No | 34 (94) | 8 (100) | 15 (94) |
Yes | 2 (6) | 0 (0) | 1 (6) |
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Magistri, P.; Catellani, B.; Frassoni, S.; Guidetti, C.; Olivieri, T.; Assirati, G.; Caporali, C.; Pecchi, A.; Serra, V.; Ballarin, R.; et al. Robotic Liver Resection Versus Percutaneous Ablation for Early HCC: Short- and Long-Term Results. Cancers 2020, 12, 3578. https://doi.org/10.3390/cancers12123578
Magistri P, Catellani B, Frassoni S, Guidetti C, Olivieri T, Assirati G, Caporali C, Pecchi A, Serra V, Ballarin R, et al. Robotic Liver Resection Versus Percutaneous Ablation for Early HCC: Short- and Long-Term Results. Cancers. 2020; 12(12):3578. https://doi.org/10.3390/cancers12123578
Chicago/Turabian StyleMagistri, Paolo, Barbara Catellani, Samuele Frassoni, Cristiano Guidetti, Tiziana Olivieri, Giacomo Assirati, Cristian Caporali, Annarita Pecchi, Valentina Serra, Roberto Ballarin, and et al. 2020. "Robotic Liver Resection Versus Percutaneous Ablation for Early HCC: Short- and Long-Term Results" Cancers 12, no. 12: 3578. https://doi.org/10.3390/cancers12123578