Detailed Abstract
[Poster Presentation 2 - Liver (Liver Disease/Surgery)]
[LV PP 2-S3] Liver Resection after Chemotherapy for Patients with Cancer Invasion of Three Main Hepatic Veins
Yu SAWADA 1, Ryusei MATSUYAMA 1, Kizuki YUZA 1, Yutaro KIKUCHI 1, Kentaro MIYAKE 1, Yasuhiro YABUSHITA 1, Yuki HOMMA 1, Takafumi KUMAMOTO 1, Kazuhisa TAKEDA 1, Itaru ENDO 1
1 Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, JAPAN
Background : Patents with cancer invasion of three main hepatic veins requires difficult surgery, and the treatment outcomes are still unclear.
Methods : We retrospectively examined the outcomes of 8 patients who underwent hepatectomy due to suspicion of invasion into three main hepatic veins from 2012 to 2023. The contact distance between the tumor and hepatic vein on the planned remnant liver was measured using a horizontal CT section.
Results : Six patients had colorectal liver metastasis and 2 patients had intrahepatic cholangiocarcinoma. The median maximum tumor diameter was 4.6cm (2.1-11). All patients underwent preoperative chemotherapy, and the median chemotherapy period was 5 months (4-10). The median contact distance between the tumor and hepatic vein was 1.4 cm (0.5-1.6). In 3 patients with the contact distance of less than 1 cm, hepatic vein reconstruction on the planned remnant liver was not required, and in 5 patients with the contact distance of 1 cm or more, hepatic vein reconstruction on the remnant liver was performed. IVC reconstruction was also performed in 5 cases. There were no surgery-related deaths, and complications of Clavien-Dindo grade III or higher were observed in 3 cases (37.5%). The 3-5 year recurrence-free survival rate was 31.3%, 15.6%, and the 3-5 year overall survival rate was 68.6%, 51.4%.
Conclusions : We performed hepatectomy for patients with invasion of three hepatic veins safely. The contact distance of 1 cm or more between the tumor and hepatic vein might be considered to be a guideline for hepatic vein reconstruction on the remnant liver.
Methods : We retrospectively examined the outcomes of 8 patients who underwent hepatectomy due to suspicion of invasion into three main hepatic veins from 2012 to 2023. The contact distance between the tumor and hepatic vein on the planned remnant liver was measured using a horizontal CT section.
Results : Six patients had colorectal liver metastasis and 2 patients had intrahepatic cholangiocarcinoma. The median maximum tumor diameter was 4.6cm (2.1-11). All patients underwent preoperative chemotherapy, and the median chemotherapy period was 5 months (4-10). The median contact distance between the tumor and hepatic vein was 1.4 cm (0.5-1.6). In 3 patients with the contact distance of less than 1 cm, hepatic vein reconstruction on the planned remnant liver was not required, and in 5 patients with the contact distance of 1 cm or more, hepatic vein reconstruction on the remnant liver was performed. IVC reconstruction was also performed in 5 cases. There were no surgery-related deaths, and complications of Clavien-Dindo grade III or higher were observed in 3 cases (37.5%). The 3-5 year recurrence-free survival rate was 31.3%, 15.6%, and the 3-5 year overall survival rate was 68.6%, 51.4%.
Conclusions : We performed hepatectomy for patients with invasion of three hepatic veins safely. The contact distance of 1 cm or more between the tumor and hepatic vein might be considered to be a guideline for hepatic vein reconstruction on the remnant liver.
SESSION
Poster Presentation 2
Zone B 3/21/2024 2:50 PM - 3:30 PM