Proposal of size-based surgical indication criteria for liver hemangioma based on a nationwide survey in Japan.

Abstract:

BACKGROUND:Surgical indications for liver hemangioma remain unclear. METHODS:Of 510 patients undergoing surgical resection for liver hemangioma in 118 Japanese centers between 1998 and 2012, abdominal symptoms, diagnostic accuracy, and surgical outcomes were analyzed to propose size-based surgical indications. Patients were classified into four groups based on tumor size: Group A ≤5 cm (n = 122, 24%), Group B 5-10 cm (n = 164, 32%), Group C 10-15 cm (n = 124, 24%), and Group D >15 cm (n = 100, 20%). RESULTS:Hemangiomas in Group A were most frequently diagnosed as malignant tumors (43.5%) due to the absence of typical imaging findings and with highest incidence of positive HBV (15.7%). Diagnostic accuracy was 98.4% in Groups B to D. Liver failure after hepatectomy was higher in Group D than in Groups A to C (3.0% vs. 0.5%, P = 0.02). Only one operative death was observed (0.2%) in Group D. CONCLUSIONS:In patients with ≤5 cm hemangioma, surgical resection can be indicated when a malignant tumor cannot be ruled out. However, surgery for 5-10 cm asymptomatic hemangiomas should be limited. Experienced hepatic surgeons should conduct hepatectomy for tumors >15 cm to avoid serious morbidity or mortality.

authors

Sakamoto Y,Kokudo N,Watadani T,Shibahara J,Yamamoto M,Yamaue H,Japanese Society of Hepato-Biliary-Pancreatic Surgery.

doi

10.1002/jhbp.464

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

417-425

issue

7

eissn

1868-6974

issn

1868-6982

journal_volume

24

pub_type

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