Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis

Gianluca Cassese; Mariano C. Giglio; Alessandro Vitale; Andrea Lauterio; Matteo Serenari; Federica Cipriani; Francesco Ardito; Pasquale Perri; Daniele Nicolini; Giulio Di Gioia; Andrea Pierluigi Fontana; Quirino Lai; Simone Conci; Luca Fumagalli; Maurizio Iaria; Mattia Garancini; Sarah Molfino; Matteo Zanello; Giuliano La Barba; Maria Conticchio; Paola Germani; Simone Famularo; Maurizio Romano; Giuseppe Zimmitti; Michela De Angelis; Albert Troci; Andrea Belli; Francesco Izzo; Michele Crespi; Luigi Boccia; Mohamed Abu Hilal; Giacomo Zanus; Guido Torzilli; Paola Tarchi; Riccardo Memeo; Giorgio Ercolani; Elio Jovine; Gianluca Baiocchi; Fabrizio Romano; Raffaele Della Valle; Marco Chiarelli; Andrea Ruzzenente; Massimo Rossi; Alessandro Ferrero; Marcello Maestri; Marco Vivarelli; Gian Luca Grazi; Felice Giuliante; Luca Aldrighetti; Matteo Cescon; Luciano De Carlis; Umberto Cillo; Roberto I. Troisi; Roberto Montalti; Pierluigi Romano; Riccardo D. Carlis; Matteo Ravaioli; Francesca Ratti; Francesco Razionale; Andrea Oddi; Laura Marinelli; Ottavia Cicerone; Nadia Russolillo; Zoe Larghi Laureiro; Ivan Marchitelli; Alessia Malagnino; Mario Giuffrida; Mauro Alessandro Scotti; Cristina Ciulli; Valentina Ferraro; Alessandro Cucchetti; Annachiara Casella; Davide Cosola; Matteo Donadon; Patrizia Pelizzo; Alberto Manzoni; Guido Mantovani; Francesco Cammarata; Renato Patrone

doi:10.1016/j.hpb.2025.01.009

Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis

Gianluca Cassese, Mariano C. Giglio, Alessandro Vitale, Andrea Lauterio, Matteo Serenari, Federica Cipriani, Francesco Ardito, Pasquale Perri, Daniele Nicolini, Giulio Di Gioia, Andrea Pierluigi Fontana, Quirino Lai, Simone Conci, Luca Fumagalli, Maurizio Iaria, Mattia Garancini, Sarah Molfino, Matteo Zanello, Giuliano La Barba, Maria ConticchioPaola Germani, Simone Famularo, Maurizio Romano, Giuseppe Zimmitti, Michela De Angelis, Albert Troci, Andrea Belli, Francesco Izzo, Michele Crespi, Luigi Boccia, Mohamed Abu Hilal, Giacomo Zanus, Guido Torzilli, Paola Tarchi, Riccardo Memeo, Giorgio Ercolani, Elio Jovine, Gianluca Baiocchi, Fabrizio Romano, Raffaele Della Valle, Marco Chiarelli, Andrea Ruzzenente, Massimo Rossi, Alessandro Ferrero, Marcello Maestri, Marco Vivarelli, Gian Luca Grazi, Felice Giuliante, Luca Aldrighetti, Matteo Cescon, Luciano De Carlis, Umberto Cillo, Roberto I. Troisi, Roberto Montalti, Pierluigi Romano, Riccardo D. Carlis, Matteo Ravaioli, Francesca Ratti, Francesco Razionale, Andrea Oddi, Laura Marinelli, Ottavia Cicerone, Nadia Russolillo, Zoe Larghi Laureiro, Ivan Marchitelli, Alessia Malagnino, Mario Giuffrida, Mauro Alessandro Scotti, Cristina Ciulli, Valentina Ferraro, Alessandro Cucchetti, Annachiara Casella, Davide Cosola, Matteo Donadon, Patrizia Pelizzo, Alberto Manzoni, Guido Mantovani, Francesco Cammarata, Renato Patrone

Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review

Abstract

Background: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far. Methods: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality. Results: 627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]; p < 0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491). Conclusion: MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.

Lingua originale	Inglese
pagine (da-a)	649-659
Numero di pagine	11
Rivista	HPB
Volume	27
Numero di pubblicazione	5
DOI	https://doi.org/10.1016/j.hpb.2025.01.009
Stato di pubblicazione	Pubblicato - mag 2025
Pubblicato esternamente	Sì

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10.1016/j.hpb.2025.01.009

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Cassese, G., C. Giglio, M., Vitale, A., Lauterio, A., Serenari, M., Cipriani, F., Ardito, F., Perri, P., Nicolini, D., Di Gioia, G., Fontana, A. P., Lai, Q., Conci, S., Fumagalli, L., Iaria, M., Garancini, M., Molfino, S., Zanello, M., La Barba, G., ... Patrone, R. (2025). Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis. HPB, 27(5), 649-659. https://doi.org/10.1016/j.hpb.2025.01.009

@article{42190d3609db4b50b4d721aa8c9be894,

title = "Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis",

abstract = "Background: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far. Methods: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality. Results: 627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95\%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95\%CI 0.13-0.58]; p < 0.001) and of developing postoperative ascites (OR 0.56 [95\%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95\%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491). Conclusion: MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.",

author = "Gianluca Cassese and \{C. Giglio\}, Mariano and Alessandro Vitale and Andrea Lauterio and Matteo Serenari and Federica Cipriani and Francesco Ardito and Pasquale Perri and Daniele Nicolini and \{Di Gioia\}, Giulio and Fontana, \{Andrea Pierluigi\} and Quirino Lai and Simone Conci and Luca Fumagalli and Maurizio Iaria and Mattia Garancini and Sarah Molfino and Matteo Zanello and \{La Barba\}, Giuliano and Maria Conticchio and Paola Germani and Simone Famularo and Maurizio Romano and Giuseppe Zimmitti and \{De Angelis\}, Michela and Albert Troci and Andrea Belli and Francesco Izzo and Michele Crespi and Luigi Boccia and \{Abu Hilal\}, Mohamed and Giacomo Zanus and Guido Torzilli and Paola Tarchi and Riccardo Memeo and Giorgio Ercolani and Elio Jovine and Gianluca Baiocchi and Fabrizio Romano and \{Della Valle\}, Raffaele and Marco Chiarelli and Andrea Ruzzenente and Massimo Rossi and Alessandro Ferrero and Marcello Maestri and Marco Vivarelli and Grazi, \{Gian Luca\} and Felice Giuliante and Luca Aldrighetti and Matteo Cescon and \{De Carlis\}, Luciano and Umberto Cillo and \{I. Troisi\}, Roberto and Roberto Montalti and Pierluigi Romano and Carlis, \{Riccardo D.\} and Matteo Ravaioli and Francesca Ratti and Francesco Razionale and Andrea Oddi and Laura Marinelli and Ottavia Cicerone and Nadia Russolillo and \{Larghi Laureiro\}, Zoe and Ivan Marchitelli and Alessia Malagnino and Mario Giuffrida and \{Alessandro Scotti\}, Mauro and Cristina Ciulli and Valentina Ferraro and Alessandro Cucchetti and Annachiara Casella and Davide Cosola and Matteo Donadon and Patrizia Pelizzo and Alberto Manzoni and Guido Mantovani and Francesco Cammarata and Renato Patrone",

note = "Publisher Copyright: {\textcopyright} 2025 International Hepato-Pancreato-Biliary Association Inc.",

year = "2025",

month = may,

doi = "10.1016/j.hpb.2025.01.009",

language = "English",

volume = "27",

pages = "649--659",

journal = "HPB",

issn = "1365-182X",

publisher = "Elsevier B.V.",

number = "5",

}

Cassese, G, C. Giglio, M, Vitale, A, Lauterio, A, Serenari, M, Cipriani, F, Ardito, F, Perri, P, Nicolini, D, Di Gioia, G, Fontana, AP, Lai, Q, Conci, S, Fumagalli, L, Iaria, M, Garancini, M, Molfino, S, Zanello, M, La Barba, G, Conticchio, M, Germani, P, Famularo, S, Romano, M, Zimmitti, G, De Angelis, M, Troci, A, Belli, A, Izzo, F, Crespi, M, Boccia, L, Abu Hilal, M, Zanus, G, Torzilli, G, Tarchi, P, Memeo, R, Ercolani, G, Jovine, E, Baiocchi, G, Romano, F, Della Valle, R, Chiarelli, M, Ruzzenente, A, Rossi, M, Ferrero, A, Maestri, M, Vivarelli, M, Grazi, GL, Giuliante, F, Aldrighetti, L, Cescon, M, De Carlis, L, Cillo, U, I. Troisi, R, Montalti, R, Romano, P, Carlis, RD, Ravaioli, M, Ratti, F, Razionale, F, Oddi, A, Marinelli, L, Cicerone, O, Russolillo, N, Larghi Laureiro, Z, Marchitelli, I, Malagnino, A, Giuffrida, M, Alessandro Scotti, M, Ciulli, C, Ferraro, V, Cucchetti, A, Casella, A, Cosola, D, Donadon, M, Pelizzo, P, Manzoni, A, Mantovani, G, Cammarata, F & Patrone, R 2025, 'Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis', HPB, vol. 27, n. 5, pagg. 649-659. https://doi.org/10.1016/j.hpb.2025.01.009

TY - JOUR

T1 - Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C

T2 - an Italian multicentric analysis

AU - Cassese, Gianluca

AU - C. Giglio, Mariano

AU - Vitale, Alessandro

AU - Lauterio, Andrea

AU - Serenari, Matteo

AU - Cipriani, Federica

AU - Ardito, Francesco

AU - Perri, Pasquale

AU - Nicolini, Daniele

AU - Di Gioia, Giulio

AU - Fontana, Andrea Pierluigi

AU - Lai, Quirino

AU - Conci, Simone

AU - Fumagalli, Luca

AU - Iaria, Maurizio

AU - Garancini, Mattia

AU - Molfino, Sarah

AU - Zanello, Matteo

AU - La Barba, Giuliano

AU - Conticchio, Maria

AU - Germani, Paola

AU - Famularo, Simone

AU - Romano, Maurizio

AU - Zimmitti, Giuseppe

AU - De Angelis, Michela

AU - Troci, Albert

AU - Belli, Andrea

AU - Izzo, Francesco

AU - Crespi, Michele

AU - Boccia, Luigi

AU - Abu Hilal, Mohamed

AU - Zanus, Giacomo

AU - Torzilli, Guido

AU - Tarchi, Paola

AU - Memeo, Riccardo

AU - Ercolani, Giorgio

AU - Jovine, Elio

AU - Baiocchi, Gianluca

AU - Romano, Fabrizio

AU - Della Valle, Raffaele

AU - Chiarelli, Marco

AU - Ruzzenente, Andrea

AU - Rossi, Massimo

AU - Ferrero, Alessandro

AU - Maestri, Marcello

AU - Vivarelli, Marco

AU - Grazi, Gian Luca

AU - Giuliante, Felice

AU - Aldrighetti, Luca

AU - Cescon, Matteo

AU - De Carlis, Luciano

AU - Cillo, Umberto

AU - I. Troisi, Roberto

AU - Montalti, Roberto

AU - Romano, Pierluigi

AU - Carlis, Riccardo D.

AU - Ravaioli, Matteo

AU - Ratti, Francesca

AU - Razionale, Francesco

AU - Oddi, Andrea

AU - Marinelli, Laura

AU - Cicerone, Ottavia

AU - Russolillo, Nadia

AU - Larghi Laureiro, Zoe

AU - Marchitelli, Ivan

AU - Malagnino, Alessia

AU - Giuffrida, Mario

AU - Alessandro Scotti, Mauro

AU - Ciulli, Cristina

AU - Ferraro, Valentina

AU - Cucchetti, Alessandro

AU - Casella, Annachiara

AU - Cosola, Davide

AU - Donadon, Matteo

AU - Pelizzo, Patrizia

AU - Manzoni, Alberto

AU - Mantovani, Guido

AU - Cammarata, Francesco

AU - Patrone, Renato

PY - 2025/5

Y1 - 2025/5

N2 - Background: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far. Methods: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality. Results: 627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]; p < 0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491). Conclusion: MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.

AB - Background: Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far. Methods: Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality. Results: 627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]; p < 0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491). Conclusion: MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.

UR - https://www.scopus.com/pages/publications/85217981977

U2 - 10.1016/j.hpb.2025.01.009

DO - 10.1016/j.hpb.2025.01.009

M3 - Article

SN - 1365-182X

VL - 27

SP - 649

EP - 659

JO - HPB

JF - HPB

IS - 5

ER -

Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis

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