Novel Benchmark Values for Open Major Anatomic Liver Resection in Non-cirrhotic Patients
Richard Sousa da Silva
(1)
,
Eva Breuer
(1)
,
Sadhana Shankar
(2)
,
Shoji Kawakatsu
(3)
,
Wacław Hołówko
(4)
,
João Santos Coelho
(5)
,
Heithem Jeddou
(6)
,
Teiichi Sugiura
(7)
,
Mohammed Ghallab
(8)
,
Doris da Silva
(9)
,
Genki Watanabe
(10)
,
Florin Botea
(11)
,
Nozomu Sakai
(12)
,
Pietro Addeo
(13, 10)
,
Stylianos Tzedakis
(14, 15, 16)
,
Fabian Bartsch
(17)
,
Kaja Balcer
(18)
,
Chetana Lim
(19)
,
Fabien Werey
(20)
,
Victor Lopez-Lopez
(21)
,
Luciana Peralta Montero
(22)
,
Rodrigo Sanchez Claria
(22)
,
Jennifer Leiting
(23)
,
Neeta Vachharajani
(24)
,
Eve Hopping
(25)
,
Orlando Torres
(26)
,
Satoshi Hirano
(27)
,
Daan Andel
(28)
,
Jeroen Hagendoorn
(28)
,
Alicja Psica
(29)
,
Matteo Ravaioli
(30)
,
Keun Soon Ahn
(31)
,
Tim Reese
(32)
,
Leonardo Montes
(33)
,
Ganesh Gunasekaran
(34)
,
Cándido Alcázar
(35)
,
Jin Hong Lim
(36)
,
Muhammad Haroon
(37)
,
Qian Lu
(38)
,
Antonio Castaldi
(39)
,
Tatsuya Orimo
(27)
,
Beat Moeckli
(40)
,
Teresa Abadía
(41)
,
Luis Ruffolo
(42)
,
Josefina Dib Hasan
(43)
,
Francesca Ratti
(44)
,
Emmanuele Kauffmann
(45)
,
Roeland de Wilde
(46)
,
Wojciech Polak
(46)
,
Ugo Boggi
(45)
,
Luca Aldrighetti
(44)
,
Lucas Mccormack
(43)
,
Roberto Hernandez-Alejandro
(42)
,
Alejandro Serrablo
(41)
,
Christian Toso
(47)
,
Akinobu Taketomi
(27)
,
Jean Gugenheim
(48)
,
Jiahong Dong
(38)
,
Faisal Hanif
(37)
,
Joon Seong Park
(36)
,
José Ramia
(35)
,
Myron Schwartz
(34)
,
Diego Ramisch
(49)
,
Michelle de Oliveira
(1)
,
Karl Oldhafer
(32)
,
Koo Jeong Kang
(31)
,
Matteo Cescon
(50)
,
Peter Lodge
(51)
,
Inne Rinkes
(28)
,
Takehiro Noji
(52)
,
John-Edwin Thomson
(25)
,
Su Kah Goh
(25)
,
William Chapman
(53)
,
Sean Cleary
(54)
,
Juan Pekolj
(22)
,
Jean-Marc Regimbeau
(55)
,
Olivier Scatton
(56)
,
Stéphanie Truant
(18)
,
Hauke Lang
(57)
,
David Fuks
(16)
,
Philippe Bachellier
(58)
,
Masayuki Ohtsuka
(12)
,
Irinel Popescu
(11)
,
Kiyoshi Hasegawa
(10)
,
Mickaël Lesurtel
(9)
,
René Adam
(59)
,
Daniel Cherqui
(59)
,
Katsuhiko Uesaka
(7)
,
Karim Boudjema
(60)
,
Hugo Pinto-Marques
(5)
,
Michał Grąt
(4)
,
Henrik Petrowsky
(1)
,
Tomoki Ebata
(61)
,
Andreas Prachalias
(2)
,
Ricardo Robles-Campos
(62)
,
Pierre-Alain Clavien
(1)
1
University hospital of Zurich [Zurich]
2 KCH - King's College Hospital
3 Nagoya City University [Nagoya, Japan]
4 Medical University of Warsaw - Poland
5 Centro Hospitalar Universitário Lisboa Central
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
7 Shizuoka Cancer Center Hospital
8 CHB - Centre Hépato-Biliaire [Hôpital Paul Brousse]
9 Hôpital Beaujon [AP-HP]
10 UTokyo - The University of Tokyo
11 Fundeni Clinical Institute = Institutul Clinic Fundeni [Bucarest, Roumanie]
12 Chiba University Hospital
13 Pôle des Pathologies Digestives Hépatiques et Transplantation [Hôpital Hautepierre-Strasbourg]
14 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
15 HeKA - Health data- and model- driven Knowledge Acquisition
16 Hôpital Cochin [AP-HP]
17 LEM - Lille économie management - UMR 9221
18 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
19 CHU Pitié-Salpêtrière [AP-HP]
20 Chirurgie digestive [CHU Amiens]
21 Instituto Tecnológico de Tijuana = Tijuana Institute of Technology [Tijuana]
22 Hospital Italiano de Buenos Aires
23 Mayo Clinic
24 Washington University School of Medicine [Saint Louis, MO]
25 Royal Adelaide Hospital [Adelaide Australia]
26 Presidente Dutra Hospital [São Luís]
27 Hokkaido University Hospital [Sapporo]
28 UMCU - University Medical Center [Utrecht]
29 St James's University Hospital
30 IRCCS - Istituti di Ricovero e Cura a Carattere Scientifico
31 Keimyung University
32 Semmelweis University of Medicine [Budapest]
33 University Hospital [Buenos Aires]
34 MSSM - Icahn School of Medicine at Mount Sinai [New York]
35 General University Hospital of Alicante
36 Yonsei University
37 Bahria International Hospital Orchard [Lahore]
38 THU - Tsinghua University [Beijing]
39 CHU Nice [Cimiez]
40 HUG - Hôpitaux Universitaires de Genève
41 Hospital Universitario Miguel Servet
42 University of Rochester [USA]
43 Hospital Alemán [Buenos Aires]
44 IRCCS Ospedale San Raffaele [Milan, Italy]
45 UniPi - University of Pisa [Italy] = Università di Pisa [Italia] = Université de Pise [Italie]
46 Erasmus MC - Erasmus University Medical Center [Rotterdam]
47 HUG - Hôpitaux universitaires de Genève = University Hospitals of Geneva
48 CHU - Hôpital Cimiez [Nice]
49 Favaloro Foundation
50 AOUB - IRCCS Azienda Ospedaliero-Universitaria di Bologna
51 Leeds Teaching Hospitals NHS Trust
52 Hokkaido University of Science
53 WUSTL - Washington University in Saint Louis
54 Mayo Clinic [Rochester]
55 CHU Amiens-Picardie
56 PASS-CYPS - Cytométrie Pitié-Salpêtrière
57 University Medical Center [Mainz]
58 UNISTRA - Université de Strasbourg
59 Hôpital Paul Brousse
60 Hôpital Sud [CHU Rennes]
61 Nagoya University
62 IMIB - Instituto Murciano de Investigación Biosanitaria Pascual Parrilla
2 KCH - King's College Hospital
3 Nagoya City University [Nagoya, Japan]
4 Medical University of Warsaw - Poland
5 Centro Hospitalar Universitário Lisboa Central
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
7 Shizuoka Cancer Center Hospital
8 CHB - Centre Hépato-Biliaire [Hôpital Paul Brousse]
9 Hôpital Beaujon [AP-HP]
10 UTokyo - The University of Tokyo
11 Fundeni Clinical Institute = Institutul Clinic Fundeni [Bucarest, Roumanie]
12 Chiba University Hospital
13 Pôle des Pathologies Digestives Hépatiques et Transplantation [Hôpital Hautepierre-Strasbourg]
14 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
15 HeKA - Health data- and model- driven Knowledge Acquisition
16 Hôpital Cochin [AP-HP]
17 LEM - Lille économie management - UMR 9221
18 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
19 CHU Pitié-Salpêtrière [AP-HP]
20 Chirurgie digestive [CHU Amiens]
21 Instituto Tecnológico de Tijuana = Tijuana Institute of Technology [Tijuana]
22 Hospital Italiano de Buenos Aires
23 Mayo Clinic
24 Washington University School of Medicine [Saint Louis, MO]
25 Royal Adelaide Hospital [Adelaide Australia]
26 Presidente Dutra Hospital [São Luís]
27 Hokkaido University Hospital [Sapporo]
28 UMCU - University Medical Center [Utrecht]
29 St James's University Hospital
30 IRCCS - Istituti di Ricovero e Cura a Carattere Scientifico
31 Keimyung University
32 Semmelweis University of Medicine [Budapest]
33 University Hospital [Buenos Aires]
34 MSSM - Icahn School of Medicine at Mount Sinai [New York]
35 General University Hospital of Alicante
36 Yonsei University
37 Bahria International Hospital Orchard [Lahore]
38 THU - Tsinghua University [Beijing]
39 CHU Nice [Cimiez]
40 HUG - Hôpitaux Universitaires de Genève
41 Hospital Universitario Miguel Servet
42 University of Rochester [USA]
43 Hospital Alemán [Buenos Aires]
44 IRCCS Ospedale San Raffaele [Milan, Italy]
45 UniPi - University of Pisa [Italy] = Università di Pisa [Italia] = Université de Pise [Italie]
46 Erasmus MC - Erasmus University Medical Center [Rotterdam]
47 HUG - Hôpitaux universitaires de Genève = University Hospitals of Geneva
48 CHU - Hôpital Cimiez [Nice]
49 Favaloro Foundation
50 AOUB - IRCCS Azienda Ospedaliero-Universitaria di Bologna
51 Leeds Teaching Hospitals NHS Trust
52 Hokkaido University of Science
53 WUSTL - Washington University in Saint Louis
54 Mayo Clinic [Rochester]
55 CHU Amiens-Picardie
56 PASS-CYPS - Cytométrie Pitié-Salpêtrière
57 University Medical Center [Mainz]
58 UNISTRA - Université de Strasbourg
59 Hôpital Paul Brousse
60 Hôpital Sud [CHU Rennes]
61 Nagoya University
62 IMIB - Instituto Murciano de Investigación Biosanitaria Pascual Parrilla
Stylianos Tzedakis
- Fonction : Auteur
- PersonId : 1221702
- IdHAL : 160686
- ORCID : 0000-0002-5934-0320
Jean-Marc Regimbeau
- Fonction : Auteur
- PersonId : 1078724
- ORCID : 0000-0001-7631-9112
- IdRef : 076392481
Stéphanie Truant
- Fonction : Auteur
- PersonId : 1366649
- IdHAL : stephanie-truant
- ORCID : 0000-0002-2828-4864
Résumé
Objective: This study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities. Background: Outcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive procedures. Methods: A 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. Results: Of 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. Conclusion: These 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.