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Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

Robotic liver surgery (RLS) has emerged as a feasible alternative to laparoscopic or open resections with comparable perioperative outcomes. Little is known about the oncologic adequacy of RLS. The purpose of this study was to investigate the long-term oncologic outcomes for patients undergoing RLS for primary hepatobiliary malignancies.

Methods

We performed an international, multicenter, retrospective study of patients who underwent RLS for hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), or gallbladder cancer (GBC) between 2006 and 2016. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS), and overall survival (OS) were retrospectively collected and analyzed.

Results

Of the 61 included patients, 34 (56%) had RLS performed for HCC, 16 (26%) for CC, and 11 (18%) for GBC. The majority of resections were nonanatomical or segmental resections (39.3%), followed by central hepatectomy (18%), left-lateral sectionectomy (14.8%), left hepatectomy (13.1%), right hepatectomy (13.1%), and right posterior segmentectomy (1.6%). R0 resection was achieved in 94% of HCC, 68% of CC, and 81.8% of GBC patients. Median hospital stay was 5 days, and conversion to open surgery was needed in seven patients (11.5%). Grade III–IV Dindo–Clavien complications occurred in seven patients with no perioperative mortality. Median follow-up was 75 months (95% confidence interval 36–113), and 5-year OS and DFS were 56 and 38%, respectively. When stratified by tumor type, 3-year OS was 90% for HCC, 65% for GBC, and 49% for CC (p = 0.01).

Conclusions

RLS can be performed for primary hepatobiliary malignancies with long-term oncologic outcomes comparable to published open and laparoscopic data.

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Acknowledgment

The authors acknowledge Doreen Esposito, Lillian Martin, and Donielle Neal for their assistance with data collection and the institutional review board approval process.

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Sidrah Khan MD, Michele Molinari MD & Allan Tsung MD

  2. Department of Surgery, Rhode Island Hospital, Providence, RI, USA

    Rachel E. Beard MD

  3. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Peter T. Kingham MD & Thomas Boerner MD

  4. Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA

    Yuman Fong MD

  5. Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA

    John B. Martinie MD & Dioneses Vrochides MD

  6. Department of Surgery, Tulane University, New Orleans, LA, USA

    Joseph F. Buell MD

  7. Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA

    Eren Berber MD & Bora Kahramangil MD

  8. Department of General, Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital Medical School, Ghent, Belgium

    Roberto I. Troisi MD & Aude Vanlander MD

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  1. Sidrah Khan MD
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Correspondence to Allan Tsung MD.

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Khan, S., Beard, R.E., Kingham, P.T. et al. Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study. Ann Surg Oncol 25, 2652–2660 (2018). https://doi.org/10.1245/s10434-018-6629-9

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  • DOI: https://doi.org/10.1245/s10434-018-6629-9

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