Annals of Surgical Oncology

, Volume 25, Issue 9, pp 2652–2660 | Cite as

Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study

  • Sidrah Khan
  • Rachel E. Beard
  • Peter T. Kingham
  • Yuman Fong
  • Thomas Boerner
  • John B. Martinie
  • Dioneses Vrochides
  • Joseph F. Buell
  • Eren Berber
  • Bora Kahramangil
  • Roberto I. Troisi
  • Aude Vanlander
  • Michele Molinari
  • Allan TsungEmail author
Hepatobiliary Tumors



Robotic liver surgery (RLS) has emerged as a feasible alternative to laparoscopic or open resections with comparable perioperative outcomes. Little is known about the oncologic adequacy of RLS. The purpose of this study was to investigate the long-term oncologic outcomes for patients undergoing RLS for primary hepatobiliary malignancies.


We performed an international, multicenter, retrospective study of patients who underwent RLS for hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), or gallbladder cancer (GBC) between 2006 and 2016. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS), and overall survival (OS) were retrospectively collected and analyzed.


Of the 61 included patients, 34 (56%) had RLS performed for HCC, 16 (26%) for CC, and 11 (18%) for GBC. The majority of resections were nonanatomical or segmental resections (39.3%), followed by central hepatectomy (18%), left-lateral sectionectomy (14.8%), left hepatectomy (13.1%), right hepatectomy (13.1%), and right posterior segmentectomy (1.6%). R0 resection was achieved in 94% of HCC, 68% of CC, and 81.8% of GBC patients. Median hospital stay was 5 days, and conversion to open surgery was needed in seven patients (11.5%). Grade III–IV Dindo–Clavien complications occurred in seven patients with no perioperative mortality. Median follow-up was 75 months (95% confidence interval 36–113), and 5-year OS and DFS were 56 and 38%, respectively. When stratified by tumor type, 3-year OS was 90% for HCC, 65% for GBC, and 49% for CC (p = 0.01).


RLS can be performed for primary hepatobiliary malignancies with long-term oncologic outcomes comparable to published open and laparoscopic data.



The authors acknowledge Doreen Esposito, Lillian Martin, and Donielle Neal for their assistance with data collection and the institutional review board approval process.


The authors have no conflict of interest to report.


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Sidrah Khan
    • 1
  • Rachel E. Beard
    • 2
  • Peter T. Kingham
    • 3
  • Yuman Fong
    • 4
  • Thomas Boerner
    • 3
  • John B. Martinie
    • 5
  • Dioneses Vrochides
    • 5
  • Joseph F. Buell
    • 6
  • Eren Berber
    • 7
  • Bora Kahramangil
    • 7
  • Roberto I. Troisi
    • 8
  • Aude Vanlander
    • 8
  • Michele Molinari
    • 1
  • Allan Tsung
    • 1
    Email author
  1. 1.Division of Hepatobiliary and Pancreatic Surgery, Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of SurgeryRhode Island HospitalProvidenceUSA
  3. 3.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  4. 4.Department of SurgeryCity of Hope National Medical CenterDuarteUSA
  5. 5.Department of SurgeryCarolinas Medical CenterCharlotteUSA
  6. 6.Department of SurgeryTulane UniversityNew OrleansUSA
  7. 7.Department of General SurgeryCleveland ClinicClevelandUSA
  8. 8.Department of General, Hepatobiliary and Liver Transplantation SurgeryGhent University Hospital Medical SchoolGhentBelgium

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