Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

作     者：Mattia Garancini Alessandro Fogliati Mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi Antonio Rovere Luca Gianotti Fabrizio Romano Mattia Garancini;Alessandro Fogliati;Mauro Alessandro Scotti;Cristina Ciulli;Francesca Carissimi;Antonio Rovere;Luca Gianotti;Fabrizio Romano

作者机构：Unit of Hepatobiliopancreatic SurgeryDepartment of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional RadiologyDepartment of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2024年第23卷第3期

页      面：265-271页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hepatocellular carcinoma Intraoperative ultrasound Liver surgery Computed tomography Surgical procedure 

摘      要：Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-INor“SegSubTe-OUTgroups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.