Resection interventions in the treatment of hepatocellular cancer in a specialized surgery center
https://doi.org/10.29413/ABS.2023-8.3.15
Abstract
Background. The relevance of the treatment of hepatocellular cancer (HCC) is determined by a significant increase in the incidence rate and its high prevalence among primary malignant hepatic tumors.
The aim of the study. To summarize the experience of providing specialized medical care to patients with hepatocellular cancer.
Methods. We studied the direct results of treatment of patients with primary hepatic cancer treated at the Kuzbass Regional Hepatological Center for the period from January 2015 to August 2022. The materials for the study were medical records of patients with an established diagnosis of primary hepatic cancer, surgical records, results of pathohistologic examination. The exclusion criterion was diagnosed cholangiocellular carcinoma.
Results. During the period from 2015 to 2022, 59 patients with primary hepatic cancer were treated at the Kuzbass Regional Hepatological Center. Among them, hepatocellular cancer was diagnosed in 48 cases, cholangiocellular cancer – in 11 cases; radical surgery was performed in 12 patients with hepatocellular cancer; fatal outcome was noted in 1 (2.1 %) patient, complications in the postoperative period developed in 5 (41.7 %) cases and were ranked as I-3, IIIb-1 and IVb-1 according to Clavien – Dindo classification.
Conclusion. The degree of risk of severe post-resection hepatic failure should be considered one of the main criteria in choosing a strategy for radical surgical treatment. New surgical approaches (laparoscopic vascular isolation of the portal blood flow, using temporary hemostasis in laparoscopic hepatic resections and the device for its implementation) in resection surgery of primary hepatic cancer can improve the immediate results of treatment.
About the Authors
V. A. PeltsRussian Federation
Vladislav A. Pelts – Cand. Sc. (Med.), Head of the Kuzbass Regional Hepatological Centre; Associate Professor at the Department of Advanced-Level Surgery
Nikolaya Ostrovskogo str. 22, Kemerovo 650991, Russian Federation
Voroshilova str. 22a, Kemerovo 650056, Russian Federation
V. E. Tropin
Russian Federation
Valentin E. Tropin – surgeon at the Kuzbass Regional Hepatological Centre
Nikolaya Ostrovskogo str. 22, Kemerovo 650991, Russian Federation
V. A. Shatalin
Russian Federation
Vladimir A. Shatalin – Resident Physician, Surgeon at the Kuzbass Regional Hepatological Centre
Nikolaya Ostrovskogo str. 22, Kemerovo 650991, Russian Federation
References
1. Mak LY, Cruz-Ramón V, Chinchilla-López P, Torres HA, LoConte NK, Rice JP, et al. Global epidemiology, prevention, and management of hepatocellular carcinoma. Am Soc Clin Oncol Educ Book. 2018; 38: 262-279. doi: 10.1200/EDBK_200939
2. Younossi ZM, Otgonsuren M, Henry L, Venkatesan C, Mishra A, Erario M, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology. 2015; 62: 1723-1730. doi: 10.1002/hep.28123
3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015, 136(5): E359-E386. doi: 10.1002/ijc.29210
4. Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013; 132(5): 1133-1145. doi: 10.1002/ijc.27711
5. Morise Z, Aldrighetti L, Belli G, Ratti F, Belli A, Cherqui D, et al. Laparoscopic repeat liver resection for hepatocellular carcinoma: A multicentre propensity score-based study. BJS. 2020; 107(7): 889-895. doi: 10.1002/bjs.11436
6. Davydov MI, Aksel EM (eds). Statistics of malignant neoplasms in Russia and CIS countries in 2012. Moscow; 2014. (In Russ.).
7. Kaprin AD, Starinsky VV, Petrova GV. The state of cancer care for the population of the Russian Federation in 2014. Moscow; 2015. (In Russ.).
8. Voskanyan SE, Rudakov VS, Shabalin MV, Artemyev AI, Bashkov AN, Kolyshev IYu, et at. “Reversal” ALPPS in patient with hepatocellular carcinoma and liver cirrhosis. First clinical case in Russia. Annals of HPB Surgery. 2021; 26(3): 142-148. (In Russ.). doi: 10.16931/1995-5464.2021-3-142-148
9. Petrin AM, Kovalenko DE, Alikhanov RB, Efanov MG. The evolution of the concept of laparoscopic liver resection based on materials of international conciliatory conferences. Annals of HPB Surgery. 2020; 25(3): 112-122. (In Russ.). doi: 10.16931/1995-5464.20203112-122
10. Adam R, Laurent A, Azoulay D, Castaing D, Bismuth H. Two-stage hepatectomy: A planned strategy to treat irresectable liver tumors. Ann Surg. 2000; 232: 777-785. doi: 10.1097/00000658-200012000-00006
11. Melekhina OV, Efanov MG, Alikhanov RB, Tsvirkun VV, Kulezneva YuV, Starostina NS, et al. Surgical methods for liver failure prevention after advanced hepatectomies. Annals of HPB Surgery. 2016; 21(3): 47-55. (In Russ.). doi: 10.16931/1995-5464.2016347-55
Review
For citations:
Pelts V.A., Tropin V.E., Shatalin V.A. Resection interventions in the treatment of hepatocellular cancer in a specialized surgery center. Acta Biomedica Scientifica. 2023;8(3):138-144. https://doi.org/10.29413/ABS.2023-8.3.15