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Does the Pringle maneuver affect survival and recurrence following surgical resection for hepatocellular carcinoma? A western series of 441 patients
Author(s) -
Famularo Simone,
Giani Alessandro,
Di Sandro Stefano,
Sandini Marta,
Giacomoni Alessandro,
Pinotti Enrico,
Lauterio Andrea,
Gianotti Luca,
De Carlis Luciano,
Romano Fabrizio
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24819
Subject(s) - medicine , hepatocellular carcinoma , resection , surgery , overall survival , hepatectomy , cohort , retrospective cohort study , carcinoma , stage (stratigraphy) , gastroenterology , paleontology , biology
Background The impact of the Pringle maneuver (PM) on long‐term outcome after curative resection for hepatocellular carcinoma (HCC) is controversial, with eastern series reporting conflicting results. We aim to evaluate the impact of the PM in a western cohort. Methods We retrospectively analyzed patients with HCC who underwent liver resection between January 2001 and August 2015. Patients were divided in two groups based the use of the PM during resection. Primary outcomes were overall survival (OS) and disease‐free survival (DFS). Results A total of 441 patients were analyzed. Of these, 176 patients (39.9%) underwent PM. Median OS was 46.4 months (95%CI: 34.1‐58.7) for the PM group and 56.5 months (95%CI: 37.1‐75.9) for the no‐PM group ( P = 0.188), with a median DFS of 26.7 months (95%CI: 15.7‐37.7) and 24.9 months (95%CI: 18.1‐31.7), respectively ( P = 0.883). Conclusions These results suggest that PM does not increase the risk of tumor recurrence or decrease long‐term survival.