TY - JOUR
T1 - A multicentre retrospective analysis on growth of residual hepatocellular adenoma after resection
AU - Klompenhouwer, Anne J.
AU - van Rosmalen, Belle V.
AU - Haring, Martijn P.D.
AU - Thomeer, Maarten G.J.
AU - Doukas, Michail
AU - Verheij, Joanne
AU - de Meijer, Vincent E.
AU - van Gulik, Thomas M.
AU - Takkenberg, Robert B.
AU - Kazemier, Geert
AU - Nevens, Frederik
AU - de Man, Robert A.
AU - Ijzermans, Jan N.M.
N1 - Funding Information: This manuscript was written on behalf of the Dutch Benign Liver Tumor Group (DBLTG). Publisher Copyright: © 2020 The Authors. Liver International published by John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background & Aims: Hepatocellular adenoma (HCA) is a benign liver tumour that may require resection in select cases. The aim of this study was to the assess growth of residual HCA in the remnant liver and to advise on an evidence-based management strategy. Method: This multicentre retrospective cohort study included all patients with HCA who underwent surgery of HCA and had residual HCA in the remnant liver. Growth was defined as an increase of >20% in transverse diameter (RECIST criteria). Data on patient and HCA characteristics, diagnostic work-up, treatment and follow-up were documented and analysed. Results: A total of 134 patients were included, one male. At diagnosis, median age was 38yrs (IQR 30.0-44.0) and median BMI was 29.9 kg/m2 (IQR 24.6-33.3). After resection, median number of residual sites of HCA was 3 (IQR 2-6). Follow-up of residual HCA showed regression in 24.6%, stable HCA in 61.9% and growth of at least one lesion in 11.2%. Three patients (2.2%) developed new HCA that were not visible on imaging prior to surgery. Four patients (3%, one male) underwent an intervention as growth was progressive. No statistically significant differences in clinical characteristics were found between patients with growing residual or new HCA versus those with stable or regressing residual HCA. Conclusion: In patients with multiple HCA who undergo resection, growth of residual HCA is not uncommon but interventions are rarely needed as most lesions stabilize and do not show progressive growth. Surveillance is indicated when residual HCA show growth after resection, enabling intervention in case of progressive growth.
AB - Background & Aims: Hepatocellular adenoma (HCA) is a benign liver tumour that may require resection in select cases. The aim of this study was to the assess growth of residual HCA in the remnant liver and to advise on an evidence-based management strategy. Method: This multicentre retrospective cohort study included all patients with HCA who underwent surgery of HCA and had residual HCA in the remnant liver. Growth was defined as an increase of >20% in transverse diameter (RECIST criteria). Data on patient and HCA characteristics, diagnostic work-up, treatment and follow-up were documented and analysed. Results: A total of 134 patients were included, one male. At diagnosis, median age was 38yrs (IQR 30.0-44.0) and median BMI was 29.9 kg/m2 (IQR 24.6-33.3). After resection, median number of residual sites of HCA was 3 (IQR 2-6). Follow-up of residual HCA showed regression in 24.6%, stable HCA in 61.9% and growth of at least one lesion in 11.2%. Three patients (2.2%) developed new HCA that were not visible on imaging prior to surgery. Four patients (3%, one male) underwent an intervention as growth was progressive. No statistically significant differences in clinical characteristics were found between patients with growing residual or new HCA versus those with stable or regressing residual HCA. Conclusion: In patients with multiple HCA who undergo resection, growth of residual HCA is not uncommon but interventions are rarely needed as most lesions stabilize and do not show progressive growth. Surveillance is indicated when residual HCA show growth after resection, enabling intervention in case of progressive growth.
KW - adenoma liver cell
KW - follow-up studies
KW - surgical procedure
UR - http://www.scopus.com/inward/record.url?scp=85084157384&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/liv.14467
DO - https://doi.org/10.1111/liv.14467
M3 - Article
C2 - 32279413
SN - 1478-3223
VL - 40
SP - 2272
EP - 2278
JO - Liver international
JF - Liver international
IS - 9
ER -