European experience of 573 liver resections for hepatocellular adenoma

A cross-sectional study by the AFC-HCA-2013 study group

Alexis Laurent, Safi Dokmak, Jean Charles Nault, François René Pruvot, Jean Michel Fabre, Christian Letoublon, Philippe Bachellier, Lorenzo Capussotti, Olivier Farges, Jean Yves Mabrut, Yves Patrice Le Treut, Ahmet Ayav, Bertrand Suc, Olivier Soubrane, Gilles Mentha, Irinel Popescu, Marco Montorsi, Nicolas Demartines, Jacques Belghiti, Guido Torzilli & 2 others Daniel Cherqui, Jean Hardwigsen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Hepatocellular adenoma (HCA) is a benign hepatic lesion that may be complicated by bleeding and malignant transformation. The aim of the present study is to report on large series of liver resections for HCA and assess the incidence of hemorrhage and malignant transformation. Methods: A retrospective cross-sectional study, from 27 European high-volume HPB units. Results: 573 patients were analyzed. The female: male gender ratio was 8:2, mean age: 37 ± 10 years.Of the 84 (14%) patients whose initial presentation was hemorrhagic shock (Hemorrhagic HCAs), hemostatic intervention was urgently required in 25 (30%) patients. No patients died after intervention. Tumor size was >5 cm in 74% in hemorrhagic HCAs and 64% in non-hemorrhagic HCAs (p <0.001).In non-hemorrhagic HCAs (n = 489), 5% presented with malignant transformation. Male status and tumor size >10 cm were the two predictive factors. Liver resections included major hepatectomy in 25% and a laparoscopic approach in 37% of the patients. In non-hemorrhagic HCAs, there was no mortality and major complications occurred in 9% of patients. Discussion: Liver resection for HCA is safe. Presentation with hemorrhage was associated with larger tumor size. In males with a HCA >10 cm, a HCC should be suspected. In such situation, a preoperative biopsy is preferable and an oncological liver resection should be considered.

Original languageEnglish
JournalHPB
DOIs
Publication statusAccepted/In press - Apr 25 2016

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Liver Cell Adenoma
Cross-Sectional Studies
Liver
Hemorrhage
Hemorrhagic Shock
Hepatectomy
Hemostatics
Neoplasms
Biopsy
Mortality
Incidence

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Laurent, A., Dokmak, S., Nault, J. C., Pruvot, F. R., Fabre, J. M., Letoublon, C., ... Hardwigsen, J. (Accepted/In press). European experience of 573 liver resections for hepatocellular adenoma: A cross-sectional study by the AFC-HCA-2013 study group. HPB. https://doi.org/10.1016/j.hpb.2016.06.011

European experience of 573 liver resections for hepatocellular adenoma : A cross-sectional study by the AFC-HCA-2013 study group. / Laurent, Alexis; Dokmak, Safi; Nault, Jean Charles; Pruvot, François René; Fabre, Jean Michel; Letoublon, Christian; Bachellier, Philippe; Capussotti, Lorenzo; Farges, Olivier; Mabrut, Jean Yves; Le Treut, Yves Patrice; Ayav, Ahmet; Suc, Bertrand; Soubrane, Olivier; Mentha, Gilles; Popescu, Irinel; Montorsi, Marco; Demartines, Nicolas; Belghiti, Jacques; Torzilli, Guido; Cherqui, Daniel; Hardwigsen, Jean.

In: HPB, 25.04.2016.

Research output: Contribution to journalArticle

Laurent, A, Dokmak, S, Nault, JC, Pruvot, FR, Fabre, JM, Letoublon, C, Bachellier, P, Capussotti, L, Farges, O, Mabrut, JY, Le Treut, YP, Ayav, A, Suc, B, Soubrane, O, Mentha, G, Popescu, I, Montorsi, M, Demartines, N, Belghiti, J, Torzilli, G, Cherqui, D & Hardwigsen, J 2016, 'European experience of 573 liver resections for hepatocellular adenoma: A cross-sectional study by the AFC-HCA-2013 study group', HPB. https://doi.org/10.1016/j.hpb.2016.06.011
Laurent, Alexis ; Dokmak, Safi ; Nault, Jean Charles ; Pruvot, François René ; Fabre, Jean Michel ; Letoublon, Christian ; Bachellier, Philippe ; Capussotti, Lorenzo ; Farges, Olivier ; Mabrut, Jean Yves ; Le Treut, Yves Patrice ; Ayav, Ahmet ; Suc, Bertrand ; Soubrane, Olivier ; Mentha, Gilles ; Popescu, Irinel ; Montorsi, Marco ; Demartines, Nicolas ; Belghiti, Jacques ; Torzilli, Guido ; Cherqui, Daniel ; Hardwigsen, Jean. / European experience of 573 liver resections for hepatocellular adenoma : A cross-sectional study by the AFC-HCA-2013 study group. In: HPB. 2016.
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T1 - European experience of 573 liver resections for hepatocellular adenoma

T2 - A cross-sectional study by the AFC-HCA-2013 study group

AU - Laurent, Alexis

AU - Dokmak, Safi

AU - Nault, Jean Charles

AU - Pruvot, François René

AU - Fabre, Jean Michel

AU - Letoublon, Christian

AU - Bachellier, Philippe

AU - Capussotti, Lorenzo

AU - Farges, Olivier

AU - Mabrut, Jean Yves

AU - Le Treut, Yves Patrice

AU - Ayav, Ahmet

AU - Suc, Bertrand

AU - Soubrane, Olivier

AU - Mentha, Gilles

AU - Popescu, Irinel

AU - Montorsi, Marco

AU - Demartines, Nicolas

AU - Belghiti, Jacques

AU - Torzilli, Guido

AU - Cherqui, Daniel

AU - Hardwigsen, Jean

PY - 2016/4/25

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N2 - Background: Hepatocellular adenoma (HCA) is a benign hepatic lesion that may be complicated by bleeding and malignant transformation. The aim of the present study is to report on large series of liver resections for HCA and assess the incidence of hemorrhage and malignant transformation. Methods: A retrospective cross-sectional study, from 27 European high-volume HPB units. Results: 573 patients were analyzed. The female: male gender ratio was 8:2, mean age: 37 ± 10 years.Of the 84 (14%) patients whose initial presentation was hemorrhagic shock (Hemorrhagic HCAs), hemostatic intervention was urgently required in 25 (30%) patients. No patients died after intervention. Tumor size was >5 cm in 74% in hemorrhagic HCAs and 64% in non-hemorrhagic HCAs (p <0.001).In non-hemorrhagic HCAs (n = 489), 5% presented with malignant transformation. Male status and tumor size >10 cm were the two predictive factors. Liver resections included major hepatectomy in 25% and a laparoscopic approach in 37% of the patients. In non-hemorrhagic HCAs, there was no mortality and major complications occurred in 9% of patients. Discussion: Liver resection for HCA is safe. Presentation with hemorrhage was associated with larger tumor size. In males with a HCA >10 cm, a HCC should be suspected. In such situation, a preoperative biopsy is preferable and an oncological liver resection should be considered.

AB - Background: Hepatocellular adenoma (HCA) is a benign hepatic lesion that may be complicated by bleeding and malignant transformation. The aim of the present study is to report on large series of liver resections for HCA and assess the incidence of hemorrhage and malignant transformation. Methods: A retrospective cross-sectional study, from 27 European high-volume HPB units. Results: 573 patients were analyzed. The female: male gender ratio was 8:2, mean age: 37 ± 10 years.Of the 84 (14%) patients whose initial presentation was hemorrhagic shock (Hemorrhagic HCAs), hemostatic intervention was urgently required in 25 (30%) patients. No patients died after intervention. Tumor size was >5 cm in 74% in hemorrhagic HCAs and 64% in non-hemorrhagic HCAs (p <0.001).In non-hemorrhagic HCAs (n = 489), 5% presented with malignant transformation. Male status and tumor size >10 cm were the two predictive factors. Liver resections included major hepatectomy in 25% and a laparoscopic approach in 37% of the patients. In non-hemorrhagic HCAs, there was no mortality and major complications occurred in 9% of patients. Discussion: Liver resection for HCA is safe. Presentation with hemorrhage was associated with larger tumor size. In males with a HCA >10 cm, a HCC should be suspected. In such situation, a preoperative biopsy is preferable and an oncological liver resection should be considered.

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