Zhou CM, Cao J, Chen SK, Tuxun T, Apaer S, Wu J, Zhao JM, Wen H. Retrospective analysis based on a clinical grading system for patients with hepatic hemangioma: A single center experience. World J Gastrointest Surg 2024; 16(7): 2047-2053 [PMID: 39087105 DOI: 10.4240/wjgs.v16.i7.2047]
Corresponding Author of This Article
Hao Wen, PhD, Professor, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, No. 137 Liyushan South Road, Xinshi District, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. dr.wenhao@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Cheng-Ming Zhou, Jun Cao, Tuerhongjiang Tuxun, Shadike Apaer, Jin-Ming Zhao, Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Shao-Ke Chen, Department of Operation Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Jing Wu, Department of General Surgery, The First Teaching College, Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Hao Wen, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
Author contributions: Zhou CM was responsible for data collection and analyses, and writing of the original draft; Cao J and Wu J contributed to data collection and analyses; Chen SK performed supervision, formal analysis, validation, and data curation; Tuxun T and Apaer S revised the manuscript; Zhao JM and Wen H reviewed and approved the final manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University.
Informed consent statement: Patients were apprised of their rights to informed consent and provided with a written informed consent for participation in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao Wen, PhD, Professor, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, No. 137 Liyushan South Road, Xinshi District, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. dr.wenhao@163.com
Received: February 25, 2024 Revised: May 14, 2024 Accepted: June 13, 2024 Published online: July 27, 2024 Processing time: 147 Days and 20.2 Hours
Abstract
BACKGROUND
The optimal approach for managing hepatic hemangioma is controversial.
AIM
To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.
METHODS
A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018. Patients were classified into four groups based on the clinical grading system and treatment: (1) Observation group with score < 4 (Obs score < 4); (2) Surgical group with score < 4 (Sur score < 4); (3) Observation group with score ≥ 4 (Obs score ≥ 4); and (4) Surgical group with score ≥ 4 (Sur score ≥ 4). The clinico-pathological index and outcomes were evaluated.
RESULTS
There were significantly fewer symptomatic patients in surgical groups (Sur score ≥ 4 vs Obs score ≥ 4, P < 0.001; Sur score < 4 vs Obs score < 4, χ² = 8.60, P = 0.004; Sur score ≥ 4 vs Obs score < 4, P < 0.001). The patients in Sur score ≥ 4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score ≥ 4 (P < 0.001; P < 0.001). Nevertheless, there was no significant difference in need for intervention and total patients with adverse event between the Sur score < 4 and Obs score < 4 (P > 0.05; χ² = 1.68, P > 0.05).
CONCLUSION
This clinical grading system appeared as a practical tool for hepatic hemangioma. Surgery can be suggested for patients with a score ≥ 4. For those with < 4, follow-up should be proposed.
Core Tip: With the development of surgical technique and new intervention including transcatheter arterial embolization and radiofrequency ablation used in liver surgery, the incidence of postoperative complications has been significantly decreased, however, the treatment of hepatic hemangioma still needs to consider the balance of benefit and risk, surgical indications for hepatic hemangioma remain unclear. Here, we evaluate a clinical grading system for management of hepatic hemangioma based on our 17 years of experience. The clinical grading system combined with the individual situation of patients could be helpful to select the most appropriate treatment for these lesions.
