Salvage hepatic resection after incomplete interstitial therapy for primary and secondary liver tumours

G. Torzilli, D. Del Fabbro, A. Palmisano, M. Marconi, M. Makuuchi, M. Montorsi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: When the response to percutaneous ablation therapy (PAT) of liver tumours is incomplete, surgery may be undertaken as a salvage therapy. To validate the safety and effectiveness of salvage hepatectomy, patients who had undergone PAT or no treatment before hepatectomy were compared. Methods: Of 137 patients who had hepatectomy for primary and secondary tumours, 21 had undergone PAT and 116 had surgery as primary treatment. Tumour features and the incidence of liver cirrhosis were similar in the two groups. Results: Peroperative mortality and major morbidity rates were zero and 5 per cent (one of 21) respectively among patients who had PAT before surgery, and 0.9 percent (one of 116) and zero in those who did not. Duration of operation (mean 495 versus 336 min; P <0.001), clamping time (mean 81 versus 53 min; P <0.001), blood loss (mean 519 versus 286 ml; P = 0.004), need for blood transfusion (six of 21 patients versus nine of 116; P = 0.001), and rates of thoracophrenolaparotomy (eight of 21 versus 14 of 116; P <0.001) and resection of other tissues (six of 21 versus nine of 116; P <0.001) were significantly higher in the PAT group. Conclusion: Hepatectomy after incomplete PAT is safe and effective, but more extensive procedures are necessary. The effect of salvage hepatectomy on long-term outcome is still unclear.

Original languageEnglish
Pages (from-to)208-213
Number of pages6
JournalBritish Journal of Surgery
Volume94
Issue number2
DOIs
Publication statusPublished - Feb 2007

ASJC Scopus subject areas

  • Surgery

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