Left Hemi-Hepatectomy to Resect Metastatic Tumor of Round Ligament of Liver in Patients with Ovarian Cancer

TL;DR

This study shows that left hemi-hepatectomy is a safe and effective surgical option for removing liver metastases in ovarian cancer patients.

Contribution

The study demonstrates the feasibility and safety of left hemi-hepatectomy for resecting deep peritoneal implants in the round ligament of the liver.

Findings

17 patients underwent left hemi-hepatectomy with no major complications.

14 patients achieved complete cytoreductive surgery with residual tumors less than 1 cm in 3.

Hepatic parenchymal invasion was confirmed in 58.8% of patients.

Abstract

This study suggests that left hemi-hepatectomy should be discussed preoperatively and intraoperatively for the complete resection of a metastatic tumor around the round ligament of the liver. We explain the necessity of left hemi-hepatectomy by the critical vascular anatomy and the pathological report of this study.

The objective of this study is to investigate the surgical, clinical and pathological outcomes of left hemi-hepatectomy during cytoreductive surgery (CRS) in patients with primary ovarian cancer. The electronic medical charts of patients with primary ovarian cancer who received CRS including left hemi-hepatectomy from 2000 to 2023 were reviewed and retrospectively analyzed. A total of 17 patients underwent left hemi-hepatectomy for resection of a deep peritoneal implant in the round ligament of the liver during primary CRS. Among these 17 patients, hepatic parenchymal invasion was confirmed in 10 patients (58.8%). Tumor distribution of others is as follows: Glisson’s capsule, hilum, falciform ligament and gall bladder. Fourteen patients (82.4%) achieved CRS; the remaining three patients had residual tumors less than 1 cm. The median period to subsequent chemotherapy was 21 days (range, 12–35 days). No specific complications related to left hepatectomy were identified such as liver failure or bile leakage. Left hemi-hepatectomy for complete surgical resection of a deep peritoneal implant of the round ligament of the liver is surgically feasible and safe.

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