Resecciones Hepáticas Laparoscópicas por Hepatocarcinoma: Resultados Perioperatorios y Oncológicos / Outcomes of Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Single-Center Experience

BACKGROUND: Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world. Surgery is the treatment of choice in stages 0 and A in the Barcelona Clinic Liver Cancer classification. A minimally invasive technique in this scenario has the advantage of reducing postoperative pain, blood loss, and hospital stay. We present our experience and outcomes in laparoscopic liver resection in HCC. METHODS: Retrospective descriptive analysis from all patients who underwent laparoscopic liver resection for HCC in our center between August 2006 and December 2020. RESULTS: Laparoscopic liver resection for HCC was performed in 20 patients. The median age was 70 years, and the male gender was 75%. Sixteen patients had chronic liver disease, and 87.5% were Child A. The most common liver resection was the non-anatomical (45%). 30-day morbidity was 15%, without the need for reintervention. We had no 30-day mortality and postoperative liver failure. Negative margins were achieved in 90% of patients. Median disease-free survival and overall survival were 25 and 40.5 months, respectively. CONCLUSION: Laparoscopic liver resection for the treatment of HCC in our series is safe, with no 30-day mortality, low incidence of complications, no postoperative liver failure, and suitable medium- and long-term oncological results

Trasplante hepático por metástasis hepáticas irresecables de cáncer colorrectal: revisión de la literatura / Liver transplantation for non-resectable colorectal liver metastases: A review

In Chile, colorectal cancer ranks third in incidence and fifth in mortality. Half of these patients have liver metastases at the diagnosis, and only 30% of them are resectable. Despite the development of many complex hepatobiliary procedures to achieve the total resection of metastases, the long-term survival with these techniques is not good. Liver transplantation is an alternative to treat unresectable liver metastasis from colorectal cancer with a good outcome. Several prognostic scores allow the selection of patients with good tumor biology. These patients have better overall and disease-free survival after liver transplantation. The use of immunosuppressive treatment doesn't increase recurrence, and even the pattern of tumor growth is slower in liver transplant recipients. The purpose of this review is to summarize the current evidence in this topic and to highlight the need for a formal protocol for liver transplantation for unresectable colorectal liver metastases, using living donors or marginal grafts to avoid competition with the rest of the national waiting list.