Recurrence of Liver Malignancy After Ischemia/Reperfusion Injury (annie-liver)

Aretaieion University Hospital

Status: Completed

Conditions: Liver Injury; Cancer Recurrence; Ischemic Reperfusion Injury; Liver Cancer; Malignancy

Treatments: Procedure: selective hepatic vascular exclusion; Procedure: semielective hepatic vascular exclusion

Study type: Observational

Funder types: Other

Identifiers

NCT04257240

liver IR

Details and patient eligibility

About

Severe ischemic changes of the liver remnant after hepatectomy could expedite tumor recurrence on the residual liver. Our study aimed at assessing the effect of warm ischemic/reperfusion (I/R) injuries on surgery-to-local recurrence interval and patient overall survival, during major hepatectomies under inflow and outflow vascular control.

Full description

One hundred and eighteen patients were subjected to liver resection under total inflow and outflow vascular clamping and were assigned as study group. These individuals were retrospectively matched to 112 counterparts, who underwent liver surgery applying inflow and outflow vascular clamping only of the segment harboring the tumor, sparing the liver remnant from any I/R injury (control group). The two cohorts were compared regarding recurrence-free survival and overall survival.

Enrollment: 230 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients
• American Society of Anesthesiologists (ASA) distribution I to III
• Patients scheduled for major liver resection (≥3 segments)

Exclusion criteria

• patients with extrahepatic disease
• patients with metastatic liver tumors

Trial design

230 participants in 2 patient groups

study group

Description:

patients subjected to major hepatectomy with vascular control of blood inflow and outflow of the whole liver

Treatment:

Procedure: selective hepatic vascular exclusion

control group

Description:

patients subjected to major hepatectomy by selectively clamping the portal and hepatic vessels only of the lobe harboring the tumor

Treatment:

Procedure: semielective hepatic vascular exclusion