Combined liver and multivisceral resections: A comparative analysis of short and long‐term outcomes

• Published in: Journal of surgical oncology 2020-12, Vol.122 (7), p.1435-1443
• Main Authors: Júnior, Sérgio S., Coelho, Fabricio F., Tustumi, Francisco, Cassenote, Alex J. F., Jeismann, Vagner B., Fonseca, Gilton M., Kruger, Jaime A. P., Ernani, Lucas, Cecconello, Ivan, Herman, Paulo
• Format: Article
• Language: English
• Subjects: Adult; Aged; comparative study; Female; hepatectomy; Hepatectomy - adverse effects; Hepatectomy - methods; Humans; Liver cancer; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Male; matched pair analysis; Middle Aged; Mortality; postoperative complications; Prospective Studies; survival analysis
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.26162

Background En bloc liver and adjacent organs resections are technically demanding procedures. Few case series and nonmatched comparative studies reported the outcomes of multivisceral liver resections (MLRs). Objectives To compare the short and long‐term outcomes of patients submitted MLRs with those submitted to isolated hepatectomies. Methods From a prospective database, a case‐matched 1:2 study was performed comparing MLRs and isolated hepatectomy. Additionally, a risk analysis was performed to evaluate the association between MLRs and perioperative morbidity, mortality, and long‐term survival. Results Fifty‐three MLRs were compared with 106 matched controls. Patients undergoing MLRs had longer operative time (430 [320‐525] vs 360 [270‐440] minutes, P = .005); higher estimated blood loss (600 [400‐800] vs 400 [100‐600] mL; P = .011); longer hospital stay (8 [6‐14] vs 7 [5‐9] days; P = .003); and higher postoperative mortality (9.4% vs 1.9%, P = .042). Number of resected organs was not an independent prognostic factor for perioperative major complications (odds ratio [OR], 1 organ = 1.8 [0.54‐6.05]; OR ≥ 2, organs = 4.0 [0.35‐13.84]) or perioperative mortality (OR, 1, organ = 5.2 [0.91‐29.51]; OR ≥ 2, organs = 6.5 [0.52‐79.60]). No differences in overall (P = .771) and disease‐free survival (P = .28) were observed. Conclusion MLRs are feasible with acceptable morbidity but relatively high perioperative mortality. MLRs did not negatively affect long‐term outcomes.