Impact of body mass index in elderly patients treated with laparoscopic liver resection for hepatocellular carcinoma

Maria Conticchio; Riccardo Inchingolo; Antonella Delvecchio; Francesca Ratti; Maximiliano Gelli; Massimiliano Ferdinando Anelli; Alexis Laurent; Giulio Cesare Vitali; Paolo Magistri; Giacomo Assirati; Emanuele Felli; Taiga Wakabayashi; Patrick Pessaux; Tullio Piardi; Fabrizio di Benedetto; Nicola de'Angelis; Javier Briceño; Antonio Rampoldi; Renè Adam; Daniel Cherqui; Luca Antonio Aldrighetti; Riccardo Memeo

doi:10.4240/wjgs.v15.i1.72

Impact of body mass index in elderly patients treated with laparoscopic liver resection for hepatocellular carcinoma

World J Gastrointest Surg. 2023 Jan 27;15(1):72-81. doi: 10.4240/wjgs.v15.i1.72.

Authors

Maria Conticchio¹, Riccardo Inchingolo², Antonella Delvecchio¹, Francesca Ratti³, Maximiliano Gelli⁴, Massimiliano Ferdinando Anelli⁵, Alexis Laurent⁶, Giulio Cesare Vitali⁷, Paolo Magistri⁸, Giacomo Assirati⁸, Emanuele Felli⁹, Taiga Wakabayashi⁹, Patrick Pessaux¹⁰, Tullio Piardi¹¹, Fabrizio di Benedetto⁸, Nicola de'Angelis⁶, Javier Briceño⁵, Antonio Rampoldi¹², Renè Adam¹³, Daniel Cherqui¹³, Luca Antonio Aldrighetti³, Riccardo Memeo¹

Affiliations

¹ Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" Regional General Hospital, Bari 70021, Italy.
² Interventional Radiology Unit, "F. Miulli" Regional General Hospital, Bari 70021, Italy. [email protected].
³ Unit of Hepatobiliary Surgery, San Raffaele Hospital, Milano 20132, Italy.
⁴ Departement de Chirurgie Viscérale, Gustave Roussy Cancer Campus Grand Paris, Paris 94800, France.
⁵ Unit of Oncologic and Pancreatic Surgery, Hospital University Reina Sofía, Cordoba 14004, Spain.
⁶ Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepatobiliary Surgery, Centre Hospitalier Universitaire Henri Mondor, Créteil, Paris 94000, France.
⁷ Service of Abdominal Surgery, Poliambulanza Foundation, Brescia 25124, Italy.
⁸ Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena 41121, Italy.
⁹ Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg 67000, France.
¹⁰ Service de Chirurgie Viscérale et Digestive, Nouvel Hôpital Civil, Strasbourg 67000, France.
¹¹ Department of Surgery, Hôpital Robert Debré, Reims 51092, France.
¹² Interventional Radiology Unit, Niguarda Hospital, Milan 20162, Italy.
¹³ Department of Surgery, Centre Hepatobiliaire, Hopital Paul Brousse, Paris 94000, France.

Abstract

Background: The impact of obesity on surgical outcomes in elderly patients candidate for liver surgery is still debated.

Aim: To evaluate the impact of high body mass index (BMI) on perioperative and oncological outcome in elderly patients (> 70 years old) treated with laparoscopic liver resection for hepatocellular carcinoma (HCC).

Methods: Retrospective multicenter study including 224 elderly patients (> 70 years old) operated by laparoscopy for HCC (196 with a BMI < 30 and 28 with BMI ≥ 30), observed from January 2009 to January 2019.

Results: After propensity score matching, patients in two groups presented comparable results, in terms of operative time (median range: 200 min vs 205 min, P = 0.7 respectively in non-obese and obese patients), complications rate (22% vs 26%, P = 1.0), length of hospital stay (median range: 4.5 d vs 6.0 d, P = 0.1). There are no significant differences in terms of short- and long-term postoperative results.

Conclusion: The present study showed that BMI did not impact perioperative and oncologic outcomes in elderly patients treated by laparoscopic resection for HCC.

Keywords: Body mass index; Elderly patients; Hepatocellular carcinoma; Laparoscopy; Propensity score matching; Surgical resection.