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Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study
- Source :
- ANNALS OF SURGICAL ONCOLOGY
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Objective. Robotic liver surgery (RLS) has emerged as a feasible alternative to laparoscopic or open resections with comparable perioperative outcomes. Little is known about the oncologic adequacy of RLS. The purpose of this study was to investigate the long-term oncologic outcomes for patients undergoing RLS for primary hepatobiliary malignancies. Methods. We performed an international, multicenter, retrospective study of patients who underwent RLS for hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), or gallbladder cancer (GBC) between 2006 and 2016. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS), and overall survival (OS) were retrospectively collected and analyzed. Results. Of the 61 included patients, 34 (56%) had RLS performed for HCC, 16 (26%) for CC, and 11 (18%) for GBC. The majority of resections were nonanatomical or segmental resections (39.3%), followed by central hepatectomy (18%), left-lateral sectionectomy (14.8%), left hepatectomy (13.1%), right hepatectomy (13.1%), and right posterior segmentectomy (1.6%). RO resection was achieved in 94% of HCC, 68% of CC, and 81.8% of GBC patients. Median hospital stay was 5 days, and conversion to open surgery was needed in seven patients (11.5%). Grade III-IV Dindo-Clavien complications occurred in seven patients with no perioperative mortality. Median follow-up was 75 months (95% confidence interval 36-113), and 5-year OS and DFS were 56 and 38%, respectively. When stratified by tumor type, 3-year OS was 90% for HCC, 65% for GBC, and 49% for CC (p = 0.01). Conclusions. RLS can be performed for primary hepatobiliary malignancies with long-term oncologic outcomes comparable to published open and laparoscopic data.
- Subjects :
- Male
SURGERY
GALLBLADDER CANCER
medicine.medical_treatment
030230 surgery
Cholangiocarcinoma
0302 clinical medicine
Robotic Surgical Procedures
HEPATOCELLULAR-CARCINOMA
robotic surgery
Medicine and Health Sciences
Gastrointestinal Neoplasms
Aged, 80 and over
Liver Neoplasms
Robotics
Middle Aged
Prognosis
hepatobiliary tumors
Survival Rate
Liver
Oncology
030220 oncology & carcinogenesis
Resection margin
Female
Gallbladder Neoplasms
Adult
Central Hepatectomy
medicine.medical_specialty
LAPAROSCOPIC HEPATECTOMY
Carcinoma, Hepatocellular
FEASIBILITY
HILAR CHOLANGIOCARCINOMA
Article
03 medical and health sciences
CASE-MATCHED ANALYSIS
medicine
Carcinoma
Hepatectomy
Minimally Invasive Surgical Procedures
INTRAHEPATIC CHOLANGIOCARCINOMA
Humans
RADICAL RESECTION
Gallbladder cancer
Survival rate
Aged
Retrospective Studies
business.industry
Retrospective cohort study
Perioperative
Length of Stay
medicine.disease
Surgery
Bile Duct Neoplasms
Neoplasm Recurrence, Local
business
OPEN HEPATECTOMY
Follow-Up Studies
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....d24fd1c64818c76f1f9ecfd6a3704688