Combined Ablation and Resection (CARe) as an Effective Parenchymal Sparing Treatment for Extensive XXXX .

@entity1 @entity1184 @entity5 @entity14 @entity6687 @entity204
BACKGROUND: Combined intra-operative ablation and resection (CARe) is proposed to treat extensive @entity14 ( @entity14 ). This multicenter study was conducted to evaluate overall survival (OS), local recurrence-free survival (LRFS), hepatic recurrence-free survival (HRFS) and progression-free survival (PFS), to identify factors associated with survival, and to report complications. MATERIALS AND METHODS: Four centers combined retropectively their clinical experiences regarding @entity14 treated by CARe. @entity14 characteristics, pre- and post-operative chemotherapy regimens, surgical procedures, complications and survivals were analyzed. RESULTS: Of the 288 @entity1 who received CARe, 210 (73%) had synchronous and 255 (88%) had bilateral @entity14 . Twenty-two @entity1 (8%) had @entity6687 . Median follow-up was 3.17 years (95%CI 2.83-4.08). Median OS was 3.33 years (95%CI 3.08-4.17) and 5-year OS was 37% (95%CI 29-45). One- and 5-year LRFS from ablated lesions were 87.9% (95%CI 83.3-91.2) and 78.0% (95%CI 71-83), respectively. Median HRFS and PFS were 14 months (95%CI 11-18) and 9 months (95%CI 8-11), respectively. One hundred @entity1 experienced complications: 29 grade I, 68 grade II-III-IV, and three @entity204 . In the multivariate models adjusted for center, the occurrence of complications was confirmed as a major independent factor associated with 3-year OS (HR 1.80; P=0.008). Five-year OS was 25.6% (95%CI 14.9-37.6) for @entity1 with complications and 45% (95%CI 33.3-53.4) for @entity1 without. CONCLUSIONS: Recent strategies facing advanced @entity14 include non-anatomic resections, portal-induced @entity1184 of the future remnant liver and aggressive medical preoperative treatments. CARe has the qualities of an approach that allows effective @entity5 clearance while maintaining good tolerance for the @entity1 .
