• Sousa Da SilvaRichard XRXSwiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland., Eva Breuer, Sadhana Shankar, Shoji Kawakatsu, Wacław Hołówko, Santos CoelhoJoãoJHepato-Biliary-Pancreatic and Transplantation Centre, Curry Cabral Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal., Heithem Jeddou, Teiichi Sugiura, Mohammed Ghallab, Doris Da Silva, Genki Watanabe, Florin Botea, Nozomu Sakai, Pietro Addeo, Stylianos Tzedakis, Fabian Bartsch, Kaja Balcer, Chetana Lim, Fabien Werey, Victor Lopez-Lopez, Peralta MonteroLucianaLHepato-Pancreato-Biliary Surgery Section and Liver Transplant Unit, General Surgery Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Rodrigo Sanchez Claria, Jennifer Leiting, Neeta Vachharajani, Eve Hopping, TorresOrlando J MOJMDepartment of Gastrointestinal Surgery, Hepatopancreatobiliary Unit, Presidente Dutra Hospital, São Luiz, Brazil., Satoshi Hirano, Daan Andel, Jeroen Hagendoorn, Alicja Psica, Matteo Ravaioli, Keun Soon Ahn, Tim Reese, Leonardo A Montes, Ganesh Gunasekaran, Cándido Alcázar, Jin Hong Lim, Muhammad Haroon, Qian Lu, Antonio Castaldi, Tatsuya Orimo, Beat Moeckli, Teresa Abadía, Luis Ruffolo, Dib HasanJosefinaJTransplant Unit, Hospital Aleman de Buenos Aires, Buenos Aires, Argentina., Francesca Ratti, Emmanuele F Kauffmann, Roeland F de Wilde, Wojciech G Polak, Ugo Boggi, Luca Aldrighetti, Lucas McCormack, Roberto Hernandez-Alejandro, Alejandro Serrablo, Christian Toso, Akinobu Taketomi, Jean Gugenheim, Jiahong Dong, Faisal Hanif, Joon Seong Park, José M Ramia, Myron Schwartz, Diego Ramisch, Michelle L De Oliveira, Karl J Oldhafer, Koo Jeong Kang, Matteo Cescon, Peter Lodge, RinkesInne H M BorelIHMBDepartment of Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands., Takehiro Noji, John-Edwin Thomson, Su Kah Goh, William C Chapman, Sean P Cleary, Juan Pekolj, Jean-Marc Regimbeau, Olivier Scatton, Stéphanie Truant, Hauke Lang, David Fuks, Philippe Bachellier, Masayuki Ohtsuka, Irinel Popescu, Kiyoshi Hasegawa, Mickaël Lesurtel, René Adam, Daniel Cherqui, Katsuhiko Uesaka, Karim Boudjema, Hugo Pinto-Marques, Michał Grąt, Henrik Petrowsky, Tomoki Ebata, Andreas Prachalias, Ricardo Robles-Campos, and Pierre-Alain Clavien.
• Swiss HPB and Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
• Ann. Surg. 2023 Nov 1; 278 (5): 748755748-755.

ObjectiveThis study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities.BackgroundOutcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive procedures.MethodsA standard benchmark methodology was used covering consecutive patients, who underwent open major anatomic hepatectomy from 44 high-volume liver centers from 5 continents over a 5-year period (2016-2020). Benchmark cases were low-risk non-cirrhotic patients without significant comorbidities treated in high-volume centers (≥30 major liver resections/year). Benchmark values were set at the 75th percentile of median values of all centers. Minimum follow-up period was 1 year in each patient.ResultsOf 8044 patients, 2908 (36%) qualified as benchmark (low-risk) cases. Benchmark cutoffs for all indications include R0 resection ≥78%; liver failure (grade B/C) ≤10%; bile leak (grade B/C) ≤18%; complications ≥grade 3 and CCI ® ≤46% and ≤9 at 3 months, respectively. Benchmark values differed significantly between malignant and benign conditions so that reference values must be adjusted accordingly. Extended right hepatectomy (H1, 4-8 or H4-8) disclosed a higher cutoff for liver failure, while extended left (H1-5,8 or H2-5,8) were associated with higher cutoffs for bile leaks, but had superior oncologic outcomes, when compared to formal left hepatectomy (H1-4 or H2-4). The minimal follow-up for a conclusive outcome evaluation following open anatomic major resection must be 3 months.ConclusionThese new benchmark cutoffs for open major hepatectomy provide a powerful tool to convincingly evaluate other approaches including parenchymal-sparing procedures, laparoscopic/robotic approaches, and alternative treatments, such as ablation therapy, irradiation, or novel chemotherapy regimens.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

26 keywords...

hide…