Grupos Investigadores

Líneas de Investigación

  • Identificación de nuevas dianas terapeuticas en cáncer de hígado
  • Inmunoterapia de los tumores hepáticos primarios: aplicación clínica y mecanismos de resistencia
  • Innovación en tratamiento de los tumores hepáticos mediante radioembolización (SIRT)
  • Mejora de las técnicas, indicaciones y manejo perioperatorio en el trasplante y la resección hepática de tumores hepáticos

Palabras Clave

  • Anti CTLA-4
  • Anti PD-1
  • Epigenética
  • Hipertrofia remanente
  • Inhibición selectiva
  • Inhibidores de puntos de control inmunológicos
  • Irradiación hepática selectiva
  • lncRNA
  • Radioembolización
  • Resección hepática
  • Reserva funcional hepática
  • Terapia celular adoptiva
  • Transplante hepático
  • Vacunación terapéutica
  • Ytrio90

Publicaciones Científicas desde 2018

  • Autores: Krenzien, F.; Schmelzle, M.; Pratschke, J.; et al.
    Revista: ANNALS OF SURGERY
    ISSN: 0003-4932 Vol.279 N° 2 2024 págs. 297 - 305
    Resumen
    Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments.Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature.Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias.Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: and 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset.Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.
  • Autores: Zheng, J. H.; Liang, X. (Autor de correspondencia); Wu, A. G. R.; et al.
    Revista: EJSO
    ISSN: 0748-7983 Vol.50 N° 1 2024 págs. 107252
    Resumen
    Introduction: We performed this study in order to investigate the impact of liver cirrhosis (LC) on the difficulty of minimally invasive liver resection (MILR), focusing on minor resections in anterolateral (AL) segments for primary liver malignancies.Methods: This was an international multicenter retrospective study of 3675 patients who underwent MILR across 60 centers from 2004 to 2021.Results: 1312 (35.7%) patients had no cirrhosis, 2118 (57.9%) had Child A cirrhosis and 245 (6.7%) had Child B cirrhosis. After propensity score matching (PSM), patients in Child A cirrhosis group had higher rates of open conversion (p = 0.024), blood loss >500 mls (p = 0.001), blood transfusion (p < 0.001), postoperative morbidity (p = 0.004), and in-hospital mortality (p = 0.041). After coarsened exact matching (CEM), Child A cirrhotic patients had higher open conversion rate (p = 0.05), greater median blood loss (p = 0.014) and increased postoperative morbidity (p = 0.001). Compared to Child A cirrhosis, Child B cirrhosis group had longer post-operative stay (p = 0.001) and greater major morbidity (p = 0.012) after PSM, and higher blood transfusion rates (p = 0.002), longer postoperative stay (p < 0.001), and greater major morbidity (p = 0.006) after CEM. After PSM, patients with portal hypertension experienced higher rates of blood loss >500 mls (p = 0.003) and intraoperative blood transfusion (p = 0.025).Conclusion: The presence and severity of LC affect and compound the difficulty of MILR for minor resections in the AL segments. These factors should be considered for inclusion into future difficulty scoring systems for MILR.