Assessment of the effect of the Aquamantys® system on local recurrence after hepatectomy for hepatocellular carcinoma through propensity score matching

• DOI: 10.1007/s12094-019-02092-0
• Publication Date: 2019-03-25T12:03:14Z
• Authors: M. H. Sui; H. G. Wang; M. Y. Chen; T. Wan; B. Y. Hu; Y. W. Pan; H. Li; H. Y. Cai; C. Cui; S. C. Lu
• Keywords: Male; Carcinoma, Hepatocellular; Liver Neoplasms; Blood Loss, Surgical; Electrosurgery; Margins of Excision; Middle Aged; Disease-Free Survival; Hemostasis, Surgical; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Case-Control Studies; Hepatectomy; Humans; Regression Analysis; Blood Transfusion; Female; Neoplasm Recurrence, Local; Propensity Score; Proportional Hazards Models; Retrospective Studies

To assess the effect of the intraoperative application of the Aquamantys® system to treat the hepatic resection margin on local and overall recurrence of HCC.We retrospectively analyzed 101 patients admitted from November 2016 to June 2018 who underwent hepatectomy using the Aquamantys® as hemostatic device, who were matched with 101 patients (control group) using conventional hemostatic devices through PSM. Univariate and multivariate analyses of recurrence-free survival (RFS) and local recurrence-free survival (LRFS) were performed using the Cox proportional hazard model.There were no significant differences in baseline data and surgical procedures between the two groups. The Aquamantys® group showed less blood loss (P = 0.005) and a lower blood transfusion rate (P = 0.036), while the incidences of postoperative complications of the two groups showed no difference (P = 0.266). OS rates of the Aquamantys® group and the control group were 82.6% and 84.2%, respectively (P = 0. 446), and RFS rates were 65.5% and 58.2%, respectively (P = 0.153), with no significant differences. The Aquamantys® group and the control group had two cases and 11 cases of local recurrence, respectively, with LRFS rates of 98% and 87.9%, respectively, in the follow-up period, corresponding to a significant difference (P = 0.011). Multivariate analysis showed that microvascular invasion (MVI), tumor diameter > 5 cm, and the control group were independent risk factors for LRFS.Our results indicate that application of the Aquamantys® system in hepatectomy can reduce local recurrence, but it can neither reduce overall recurrence nor improve OS.