A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance
Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs < 50 mm compared to HCAs ≥ 50 mm. Changes in final postoperative diagnosis...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2023-01-01
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| Series: | Hepatology Communications |
| Online Access: | http://journals.lww.com/10.1002/hep4.2110 |
| _version_ | 1811161615476719616 |
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| author | Martijn P. D. Haring Arthur K. E. Elfrink Christiaan A. J. Oudmaijer Paul C. M. Andel Alicia Furumaya Nenke de Jong Colin J. J. M. Willems Thijs Huits Julie M. L. Sijmons Eric J. T. Belt Koop Bosscha Esther C. J. Consten Mariëlle M. E. Coolsen Peter van Duijvendijk Joris I. Erdmann Paul Gobardhan Robbert J. de Haas Tjarda van Heek Hwai‐Ding Lam Wouter K. G. Leclercq Mike S. L. Liem Hendrik A. Marsman Gijs A. Patijn Türkan Terkivatan Babs M. Zonderhuis Izaak Quintus Molenaar Wouter W. te Riele Jeroen Hagendoorn Alexander F. M. Schaapherder Jan N. M. IJzermans Carlijn I. Buis Joost M. Klaase Koert P. de Jong Vincent E. de Meijer |
| author_facet | Martijn P. D. Haring Arthur K. E. Elfrink Christiaan A. J. Oudmaijer Paul C. M. Andel Alicia Furumaya Nenke de Jong Colin J. J. M. Willems Thijs Huits Julie M. L. Sijmons Eric J. T. Belt Koop Bosscha Esther C. J. Consten Mariëlle M. E. Coolsen Peter van Duijvendijk Joris I. Erdmann Paul Gobardhan Robbert J. de Haas Tjarda van Heek Hwai‐Ding Lam Wouter K. G. Leclercq Mike S. L. Liem Hendrik A. Marsman Gijs A. Patijn Türkan Terkivatan Babs M. Zonderhuis Izaak Quintus Molenaar Wouter W. te Riele Jeroen Hagendoorn Alexander F. M. Schaapherder Jan N. M. IJzermans Carlijn I. Buis Joost M. Klaase Koert P. de Jong Vincent E. de Meijer |
| author_sort | Martijn P. D. Haring |
| collection | DOAJ |
| description | Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs < 50 mm compared to HCAs ≥ 50 mm. Changes in final postoperative diagnosis were assessed. We performed a retrospective study that included patients who underwent resection for (suspected) HCAs in the Netherlands from 2014 to 2019. Indication for resection was analyzed and stratified for small (<50 mm) and large (≥50 mm) tumors. Logistic regression analysis was performed on factors influencing change in tumor diagnosis. Out of 222 patients who underwent surgery, 44 (20%) patients had a tumor <50 mm. Median age was 46 (interquartile range [IQR], 33–56) years in patients with small tumors and 37 (IQR, 31–46) years in patients with large tumors (p = 0.016). Patients with small tumors were more frequently men (21% vs. 5%, p = 0.002). Main indications for resection in patients with small tumors were suspicion of (pre)malignancy (55%), (previous) bleeding (14%), and male sex (11%). Patients with large tumors received operations because of tumor size >50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). No difference was observed in HCA‐subtype distribution between small and large tumors. Ninety‐six (43%) patients had a postoperative change in diagnosis. Independent risk factors for change in diagnosis were tumor size <50 mm (adjusted odds ratio [aOR], 3.4; p < 0.01), male sex (aOR, 3.7; p = 0.03), and lack of hepatobiliary contrast‐enhanced magnetic resonance imaging (CE‐MRI) (aOR, 1.8; p = 0.04). Resection for small (suspected) HCAs was mainly indicated by suspicion of (pre)malignancy, whereas for large (suspected) HCAs, tumor size was the most prevalent indication. Male sex, tumor size <50 mm, and lack of hepatobiliary CE‐MRI were independent risk factors for postoperative change in tumor diagnosis. |
| first_indexed | 2024-04-10T06:17:16Z |
| format | Article |
| id | doaj.art-5bc6211f44f94829bfd770f0d4b780d4 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T06:17:16Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-5bc6211f44f94829bfd770f0d4b780d42023-03-02T06:29:30ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2023-01-0171e2110e211010.1002/hep4.2110hep42110A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordanceMartijn P. D. Haring0Arthur K. E. ElfrinkChristiaan A. J. Oudmaijer1Paul C. M. Andel2Alicia Furumaya3Nenke de Jong4Colin J. J. M. Willems5Thijs Huits6Julie M. L. Sijmons7Eric J. T. Belt8Koop Bosscha9Esther C. J. ConstenMariëlle M. E. Coolsen10Peter van DuijvendijkJoris I. Erdmann11Paul Gobardhan12Robbert J. de Haas13Tjarda van Heek14Hwai‐Ding Lam15Wouter K. G. Leclercq16Mike S. L. Liem17Hendrik A. Marsman18Gijs A. Patijn19Türkan Terkivatan20Babs M. Zonderhuis21Izaak Quintus Molenaar22Wouter W. te Riele23Jeroen Hagendoorn24Alexander F. M. Schaapherder25Jan N. M. IJzermans26Carlijn I. Buis27Joost M. Klaase28Koert P. de Jong29Vincent E. de Meijer301 Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands4 Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Erasmus Medical Center Transplant Institute, Erasmus University Medical Center, Rotterdam, the Netherlands5 Department of Surgery, Regional Academic Cancer Center Utrecht, Utrecht Medical Center Utrecht and St. Antonius Hospital Nieuwegein, University of Utrecht, Utrecht, the Netherlands6 Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands7 Department of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands8 Department of Surgery, Maastricht University Medical Center+, University of Maastricht, Maastricht, the Netherlands9 Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands10 Department of Surgery, Máxima Medisch Centrum, Veldhoven, the Netherlands11 Department of Surgery, Albert Sweitzer Ziekenhuis, Dordrecht, the Netherlands12 Department of Surgery, Jeroen Bosch Ziekenhuis, ‘s‐Hertogenbosch, the Netherlands8 Department of Surgery, Maastricht University Medical Center+, University of Maastricht, Maastricht, the Netherlands6 Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands16 Department of Surgery, Amphia Ziekenhuis, Breda, the Netherlands17 Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands18 Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, the Netherlands19 Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, the Netherlands10 Department of Surgery, Máxima Medisch Centrum, Veldhoven, the Netherlands7 Department of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands9 Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands15 Department of Surgery, Isala Klinieken, Zwolle, the Netherlands4 Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Erasmus Medical Center Transplant Institute, Erasmus University Medical Center, Rotterdam, the Netherlands20 Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands5 Department of Surgery, Regional Academic Cancer Center Utrecht, Utrecht Medical Center Utrecht and St. Antonius Hospital Nieuwegein, University of Utrecht, Utrecht, the Netherlands5 Department of Surgery, Regional Academic Cancer Center Utrecht, Utrecht Medical Center Utrecht and St. Antonius Hospital Nieuwegein, University of Utrecht, Utrecht, the Netherlands5 Department of Surgery, Regional Academic Cancer Center Utrecht, Utrecht Medical Center Utrecht and St. Antonius Hospital Nieuwegein, University of Utrecht, Utrecht, the Netherlands19 Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, the Netherlands4 Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Erasmus Medical Center Transplant Institute, Erasmus University Medical Center, Rotterdam, the Netherlands1 Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands1 Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands1 Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands1 Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the NetherlandsHepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs < 50 mm compared to HCAs ≥ 50 mm. Changes in final postoperative diagnosis were assessed. We performed a retrospective study that included patients who underwent resection for (suspected) HCAs in the Netherlands from 2014 to 2019. Indication for resection was analyzed and stratified for small (<50 mm) and large (≥50 mm) tumors. Logistic regression analysis was performed on factors influencing change in tumor diagnosis. Out of 222 patients who underwent surgery, 44 (20%) patients had a tumor <50 mm. Median age was 46 (interquartile range [IQR], 33–56) years in patients with small tumors and 37 (IQR, 31–46) years in patients with large tumors (p = 0.016). Patients with small tumors were more frequently men (21% vs. 5%, p = 0.002). Main indications for resection in patients with small tumors were suspicion of (pre)malignancy (55%), (previous) bleeding (14%), and male sex (11%). Patients with large tumors received operations because of tumor size >50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). No difference was observed in HCA‐subtype distribution between small and large tumors. Ninety‐six (43%) patients had a postoperative change in diagnosis. Independent risk factors for change in diagnosis were tumor size <50 mm (adjusted odds ratio [aOR], 3.4; p < 0.01), male sex (aOR, 3.7; p = 0.03), and lack of hepatobiliary contrast‐enhanced magnetic resonance imaging (CE‐MRI) (aOR, 1.8; p = 0.04). Resection for small (suspected) HCAs was mainly indicated by suspicion of (pre)malignancy, whereas for large (suspected) HCAs, tumor size was the most prevalent indication. Male sex, tumor size <50 mm, and lack of hepatobiliary CE‐MRI were independent risk factors for postoperative change in tumor diagnosis.http://journals.lww.com/10.1002/hep4.2110 |
| spellingShingle | Martijn P. D. Haring Arthur K. E. Elfrink Christiaan A. J. Oudmaijer Paul C. M. Andel Alicia Furumaya Nenke de Jong Colin J. J. M. Willems Thijs Huits Julie M. L. Sijmons Eric J. T. Belt Koop Bosscha Esther C. J. Consten Mariëlle M. E. Coolsen Peter van Duijvendijk Joris I. Erdmann Paul Gobardhan Robbert J. de Haas Tjarda van Heek Hwai‐Ding Lam Wouter K. G. Leclercq Mike S. L. Liem Hendrik A. Marsman Gijs A. Patijn Türkan Terkivatan Babs M. Zonderhuis Izaak Quintus Molenaar Wouter W. te Riele Jeroen Hagendoorn Alexander F. M. Schaapherder Jan N. M. IJzermans Carlijn I. Buis Joost M. Klaase Koert P. de Jong Vincent E. de Meijer A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance Hepatology Communications |
| title | A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance |
| title_full | A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance |
| title_fullStr | A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance |
| title_full_unstemmed | A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance |
| title_short | A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance |
| title_sort | nationwide assessment of hepatocellular adenoma resection indications and pathological discordance |
| url | http://journals.lww.com/10.1002/hep4.2110 |
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