The role of resection in hepatocellular carcinoma BCLC stage B

The Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. This systematic review includes a mu...

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Autores: Lopez-Lopez, Victor|||0000-0003-1718-3352, Kalt, Fabian, Zhong, Jian-Hong, Guidetti, Cristiano, Magistri, Paolo, Di Benedetto, Fabrizio, Weinmann, Arndt, Mittler, Jens, Lang, Hauke, Sharma, Rohini, Vithayathil Mathew, J., Tariq, Samir, Sánchez-Velázquez, Patricia|||0000-0002-7902-3920, Rompianesi, Gianluca, Troisi, Roberto Ivan, Gómez Gavara, Concepción|||0000-0001-8312-3273, Dalmau, Mar|||0000-0002-2075-0912, Sanchez-Romero, Francisco Jose, Llamoza, Camilo, Tschuor, Christoph, Deniz, Uluk, Lurje, Georg, Husen, Peri, Hügli, Sandro, Jonas, Jan Philipp, Rössler, Fabian, Kron, Philipp, Ramser, Michaela, Ramirez, Pablo, Lehmann, Kuno, Robles-Campos, Ricardo, Eshmuminov, Dilmurodjon
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:306723
Acceso en línea:https://ddd.uab.cat/record/306723
https://dx.doi.org/urn:doi:10.1007/s00423-024-03466-x
Access Level:acceso abierto
Palabra clave:HCC
BCLC-B
Liver resection
Liver transplantation
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spelling The role of resection in hepatocellular carcinoma BCLC stage BA multi-institutional patient-level meta-analysis and systematic reviewLopez-Lopez, Victor|||0000-0003-1718-3352Kalt, FabianZhong, Jian-HongGuidetti, CristianoMagistri, PaoloDi Benedetto, FabrizioWeinmann, ArndtMittler, JensLang, HaukeSharma, RohiniVithayathil Mathew, J.Tariq, SamirSánchez-Velázquez, Patricia|||0000-0002-7902-3920Rompianesi, GianlucaTroisi, Roberto IvanGómez Gavara, Concepción|||0000-0001-8312-3273Dalmau, Mar|||0000-0002-2075-0912Sanchez-Romero, Francisco JoseLlamoza, CamiloTschuor, ChristophDeniz, UlukLurje, GeorgHusen, PeriHügli, SandroJonas, Jan PhilippRössler, FabianKron, PhilippRamser, MichaelaRamirez, PabloLehmann, KunoRobles-Campos, RicardoEshmuminov, DilmurodjonHCCBCLC-BLiver resectionLiver transplantationThe Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. This systematic review includes a multi-institutional meta-analysis of patient-level data. Survival, postoperative mortality, morbidity and patient selection criteria for liver resection and transplantation in BCLC stage B are explored. All clinical studies reporting HCC patients with BCLC stage B undergoing liver resection or transplantation were included. A total of 31 studies with 3163 patients were included. Patient level data was available for 580 patients from 9 studies (423 after resection and 157 after transplantation). The overall survival following resection was 50 months and recurrence-free survival was 15 months. Overall survival after transplantation was not reached and recurrence-free survival was 45 months. The major complication rate after resection was 0.11 (95%-CI, 0.0-0.17) with the 90-day mortality rate of 0.03 (95%-CI, 0.03-0.08). Child-Pugh A (93%), minor resection (60%), alpha protein level less than 400 (64%) were common in resected patients. Resected patients were mostly outside the Milan criteria (99%) with mean tumour number of 2.9. Studies reporting liver transplantation in BCLC stage B were scarce. Liver resection can be performed safely in selected patients with HCC BCLC stage B, particularly if patients present with preserved liver function. No conclusion can done on liver transplantation due to scarcity of reported studies. The online version contains supplementary material available at 10.1007/s00423-024-03466-x. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/306723https://dx.doi.org/urn:doi:10.1007/s00423-024-03466-xreponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3067232026-06-06T12:50:31Z
dc.title.none.fl_str_mv The role of resection in hepatocellular carcinoma BCLC stage B
A multi-institutional patient-level meta-analysis and systematic review
title The role of resection in hepatocellular carcinoma BCLC stage B
spellingShingle The role of resection in hepatocellular carcinoma BCLC stage B
Lopez-Lopez, Victor|||0000-0003-1718-3352
HCC
BCLC-B
Liver resection
Liver transplantation
title_short The role of resection in hepatocellular carcinoma BCLC stage B
title_full The role of resection in hepatocellular carcinoma BCLC stage B
title_fullStr The role of resection in hepatocellular carcinoma BCLC stage B
title_full_unstemmed The role of resection in hepatocellular carcinoma BCLC stage B
title_sort The role of resection in hepatocellular carcinoma BCLC stage B
dc.creator.none.fl_str_mv Lopez-Lopez, Victor|||0000-0003-1718-3352
Kalt, Fabian
Zhong, Jian-Hong
Guidetti, Cristiano
Magistri, Paolo
Di Benedetto, Fabrizio
Weinmann, Arndt
Mittler, Jens
Lang, Hauke
Sharma, Rohini
Vithayathil Mathew, J.
Tariq, Samir
Sánchez-Velázquez, Patricia|||0000-0002-7902-3920
Rompianesi, Gianluca
Troisi, Roberto Ivan
Gómez Gavara, Concepción|||0000-0001-8312-3273
Dalmau, Mar|||0000-0002-2075-0912
Sanchez-Romero, Francisco Jose
Llamoza, Camilo
Tschuor, Christoph
Deniz, Uluk
Lurje, Georg
Husen, Peri
Hügli, Sandro
Jonas, Jan Philipp
Rössler, Fabian
Kron, Philipp
Ramser, Michaela
Ramirez, Pablo
Lehmann, Kuno
Robles-Campos, Ricardo
Eshmuminov, Dilmurodjon
author Lopez-Lopez, Victor|||0000-0003-1718-3352
author_facet Lopez-Lopez, Victor|||0000-0003-1718-3352
Kalt, Fabian
Zhong, Jian-Hong
Guidetti, Cristiano
Magistri, Paolo
Di Benedetto, Fabrizio
Weinmann, Arndt
Mittler, Jens
Lang, Hauke
Sharma, Rohini
Vithayathil Mathew, J.
Tariq, Samir
Sánchez-Velázquez, Patricia|||0000-0002-7902-3920
Rompianesi, Gianluca
Troisi, Roberto Ivan
Gómez Gavara, Concepción|||0000-0001-8312-3273
Dalmau, Mar|||0000-0002-2075-0912
Sanchez-Romero, Francisco Jose
Llamoza, Camilo
Tschuor, Christoph
Deniz, Uluk
Lurje, Georg
Husen, Peri
Hügli, Sandro
Jonas, Jan Philipp
Rössler, Fabian
Kron, Philipp
Ramser, Michaela
Ramirez, Pablo
Lehmann, Kuno
Robles-Campos, Ricardo
Eshmuminov, Dilmurodjon
author_role author
author2 Kalt, Fabian
Zhong, Jian-Hong
Guidetti, Cristiano
Magistri, Paolo
Di Benedetto, Fabrizio
Weinmann, Arndt
Mittler, Jens
Lang, Hauke
Sharma, Rohini
Vithayathil Mathew, J.
Tariq, Samir
Sánchez-Velázquez, Patricia|||0000-0002-7902-3920
Rompianesi, Gianluca
Troisi, Roberto Ivan
Gómez Gavara, Concepción|||0000-0001-8312-3273
Dalmau, Mar|||0000-0002-2075-0912
Sanchez-Romero, Francisco Jose
Llamoza, Camilo
Tschuor, Christoph
Deniz, Uluk
Lurje, Georg
Husen, Peri
Hügli, Sandro
Jonas, Jan Philipp
Rössler, Fabian
Kron, Philipp
Ramser, Michaela
Ramirez, Pablo
Lehmann, Kuno
Robles-Campos, Ricardo
Eshmuminov, Dilmurodjon
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv HCC
BCLC-B
Liver resection
Liver transplantation
topic HCC
BCLC-B
Liver resection
Liver transplantation
description The Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended. This systematic review includes a multi-institutional meta-analysis of patient-level data. Survival, postoperative mortality, morbidity and patient selection criteria for liver resection and transplantation in BCLC stage B are explored. All clinical studies reporting HCC patients with BCLC stage B undergoing liver resection or transplantation were included. A total of 31 studies with 3163 patients were included. Patient level data was available for 580 patients from 9 studies (423 after resection and 157 after transplantation). The overall survival following resection was 50 months and recurrence-free survival was 15 months. Overall survival after transplantation was not reached and recurrence-free survival was 45 months. The major complication rate after resection was 0.11 (95%-CI, 0.0-0.17) with the 90-day mortality rate of 0.03 (95%-CI, 0.03-0.08). Child-Pugh A (93%), minor resection (60%), alpha protein level less than 400 (64%) were common in resected patients. Resected patients were mostly outside the Milan criteria (99%) with mean tumour number of 2.9. Studies reporting liver transplantation in BCLC stage B were scarce. Liver resection can be performed safely in selected patients with HCC BCLC stage B, particularly if patients present with preserved liver function. No conclusion can done on liver transplantation due to scarcity of reported studies. The online version contains supplementary material available at 10.1007/s00423-024-03466-x.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/306723
https://dx.doi.org/urn:doi:10.1007/s00423-024-03466-x
url https://ddd.uab.cat/record/306723
https://dx.doi.org/urn:doi:10.1007/s00423-024-03466-x
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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