Article (Scientific journals)
Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Report of an international multicenter cohort study with propensity score matching.
Brustia, Raffaele; Laurent, Alexis; Goumard, Claire et al.
2022In Surgery, 171 (5), p. 1290-1302
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Keywords :
Bile Duct Neoplasms/pathology; Bile Ducts, Intrahepatic/pathology; Cholangiocarcinoma; Cohort Studies; Hepatectomy; Humans; Laparoscopy/adverse effects; Liver/pathology; Postoperative Complications/etiology; Propensity Score; Retrospective Studies; Treatment Outcome
Abstract :
[en] BACKGROUND: Intrahepatic cholangiocarcinoma is a rare disease with a poor prognosis. In patients where surgical resection is possible, outcome is influenced by perioperative morbidity and lymph node status. Laparoscopic liver resection is associated with improved clinical and oncological outcomes in primary and metastatic liver cancer compared with open liver resection, but evidence on intrahepatic cholangiocarcinoma is still insufficient. The primary aim of this study was to compare overall survival for a large series of patients treated for intrahepatic cholangiocarcinoma by open or laparoscopic approach. Secondary objectives were to compare disease-free survival, predictors of death, and recurrence. METHODS: Patients treated with laparoscopic or open liver resection for intrahepatic cholangiocarcinoma from 2000 to 2018 from 3 large international databases were analyzed retrospectively. Each patient in the laparoscopic resection group (case) was matched with 1 open resection control (1:1 ratio), through a propensity score calculated on clinically relevant preoperative covariates. Overall and disease-free survival were compared between the matched groups. Predictors of mortality and recurrence were analyzed with Cox regression, and the Textbook Outcomes were described. RESULTS: During the study period, 855 patients met the inclusion criteria (open liver resection = 709, 82.9%; laparoscopic liver resection = 146, 17.1%). Two groups of 89 patients each were analyzed after propensity score matching, with no significant difference regarding pre- and postoperative variables. Overall survival at 1, 3, and 5 years was 92%, 75%, and 63% in the laparoscopic liver resection group versus 92%, 58%, and 49% in the open liver resection group (P = .0043). Adjusted Cox regression revealed severe postoperative complications (hazard ratio: 10.5, 95% confidence interval [1.01-109] P = .049) and steatosis (hazard ratio: 13.8, 95% confidence interval [1.23-154] P = .033) as predictors of death, and transfusion (hazard ratio: 19.2, 95% confidence interval [4.04-91.4] P < .001) and severe postoperative complications (hazard ratio: 4.07, 95% confidence interval [1.15-14.4] P = .030) as predictors of recurrence. CONCLUSION: The survival advantage of laparoscopic liver resection over open liver resection for intrahepatic cholangiocarcinoma is equivocal, given historical bias and missing data.
Disciplines :
Surgery
Oncology
Author, co-author :
Brustia, Raffaele;  Department of Digestive and Hepato-Pancreatic-Biliary Surgery, DMU CARE,
Laurent, Alexis;  Univ Paris Est Creteil, Faculté de Santé, Créteil, France and Department of
Goumard, Claire;  Department of Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital
Langella, Serena;  Department of General and Oncological Surgery, Ospedale Mauriziano, Torino,
Cherqui, Daniel;  Centre Hepato-Biliaire, AP-HP Paul Brousse Hospital, Paris-Saclay University,
Kawai, Takayuki;  Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto,
Soubrane, Olivier;  Department of Hepatobiliary Surgery, APHP, University Hospitals Paris Nord Val de
Cauchy, Francois;  Department of Hepatobiliary Surgery, APHP, University Hospitals Paris Nord Val de
Farges, Olivier;  Department of Hepatobiliary Surgery, APHP, University Hospitals Paris Nord Val de
Menahem, Benjamin;  Department of Digestive Surgery, University Hospital of Caen, France.
Hobeika, Christian;  Department of Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital
Rhaiem, Rami;  Department of Hepatobiliary, Pancreatic, and Digestive Surgery, Robert Debré
Sommacale, Daniele;  Univ Paris Est Creteil, Faculté de Santé, Créteil, France and Department of
Okumura, Shinya;  Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto,
Hofmeyr, Stefan;  Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch
Ferrero, Alessandro;  Department of General and Oncological Surgery, Ospedale Mauriziano, Torino,
Pruvot, François-René;  Department of Digestive Surgery and Transplantation, Univ Lille, CHRU Lille,
Regimbeau, Jean-Marc;  SSPC (Simplification of Surgical Patients Care), Clinical Research Unit,
Fuks, David;  Department of Digestive, Oncologic, and Metabolic Surgery, Institut Mutualiste
Vibert, Eric;  Centre Hepato-Biliaire, AP-HP Paul Brousse Hospital, Paris-Saclay University,
Scatton, Olivier;  Department of Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital
AFC-ICC-2009
AFC-LLR-2018
PRS-2019 Study, group
More authors (14 more) Less
Other collaborator :
Abba, Julio
Adam, René
Adham, Mustapha
Allard, Marc-Antoine
Ayav, Ahmet
Azoulay, Daniel
Bachellier, Philippe
Balladur, Pierre
Barbier, Louise
Barbieux, Julien
Boleslawski, Emmanuel
Boudjema, Karim
Bougard, M
Buc, Emmanuel
Bucur, Petru
Carmelo, Antoine
Chatelain, Denis
Chauvat, Jean
Cherkaoui, Zineb
Chiche, Laurence
Chirica, Mircea
Ciacio, Oriana
Codjia, Tatiana
Colli, Fabio
De Carlis, Luciano
Delpero, Jean-Robert
Demartines, Nicolas
Detry, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
Sanches, Marcelo Dias
Diouf, Momar
Doussot, Alexandre
Ducerf, Christian
El Amrani, Mehdi
Ewald, Jacques
Fabre, Jean-Marc
Fagot, Hervé
Famularo, Simone
Ferre, Léo
Fleres, Francesco
Fonseca, Gilton Marques
Gayet, Brice
Giacomoni, Alessandro
Gigot, Jean-Francois
Girard, E
Golse, Nicolas
Gregoire, Emilie
Hardwigsen, Jean
Herman, Paulo
Hor, Thevi
Jehaes, François
Kianmanesh, Ali-Reza
Komatsu, Shohei
Laroche, Sophie
Laurent, Christophe
Le Treut, Yves-Patrice
Lecolle, K
Leourier, Philippe
Lermite, Emilie
Lesurtel, Mikael
Letoublon, Christian
Leyman, Paul
Lubrano, Jean
Mabrut, Jean-Yves
Mantion, Georges
Marchese, Ugo
Memeo, Riccardo
Millet, Guillaume
Mohkam, Kayvan
Mulliri, André
Muscari, Fabrice
Navarro, Francis
Nolasco, Francisco
Nomi, Takeo
Nunoz, Jean
Nuzzo, Gennaro
Oudafal, Nassima
Pascal, Gerard
Passot, Guillaume
Patrice, D
Patrono, Damiano
Paye, François
Perdigao, Fabiano
Pessaux, Patrick
Petrucciani, Niccolo
Pittau, Gabriella
Ratajczak, C
Raventos, Artigas
Rebibo, Lionel
Resende, Vivian
Rivoire, Michel
Romagnoli, Renato
Roulin, Didier
Sa-Cunha, Antonio
Salame, Ephrem
Schielke, Astrid
Schwarz, Lilian
Scotte, Michel
Souche, François-Regis
Suc, Bertrand
Tedeschi, Michele
Thobie, Alexandre
Trechot, Boris
Truant, Stéphanie
Turini, Olivier
Uemoto, Shinji
Unterteiner, Xavier
Vanbrugghe, Charles
Zemour, Jean
More authors (98 more) Less
Language :
English
Title :
Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Report of an international multicenter cohort study with propensity score matching.
Publication date :
May 2022
Journal title :
Surgery
ISSN :
0039-6060
eISSN :
1532-7361
Publisher :
Eslevier
Volume :
171
Issue :
5
Pages :
1290-1302
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2021 Elsevier Inc. All rights reserved.
Available on ORBi :
since 30 July 2023

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