Evidence map›Paper›PMID 41507450›Full record

SynthesisAnnals of surgical oncology2026

Oncological Adequacy of R1 Vascular Margin in Minimally Invasive Liver Surgery for Hepatocellular Carcinoma and Colorectal Liver Metastases: A Meta-analysis.

Fabio Procopio, Riccardo Memeo, Daniele Del Fabbro, Schaima Abdelhadi, Christoph Reissfelder, Bjørn Edwin, Flavio Milana, Roberto Ivan Troisi, Guido Torzilli, Minimally Invasive R1 Vascular Group

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Fabio ProcopioDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Riccardo MemeoDepartment of Hepato-Biliary and Pancreatic Surgery, "F. Miulli" General Hospital, Acquaviva delle Fonti, Bari, Italy.
Daniele Del FabbroHepato-Biliary and Pancreatic Surgery Unit, Department of Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Schaima AbdelhadiDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Christoph ReissfelderDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Bjørn EdwinThe Intervention Centre, Oslo University Hospital, Oslo, Norway.
Flavio MilanaDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Roberto Ivan TroisiDepartment of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Renal Transplant Service, Federico II University, Naples, Italy.
Guido TorzilliDepartment of Biomedical Sciences, Humanitas University, Milan, Italy. guido.torzilli@hunimed.eu.ORCID http://orcid.org/0000-0001-5798-5021
Minimally Invasive R1 Vascular Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe concept of tumor-vessel detachment (R1 vascular [R1v]), has recently gained attention within the minimally invasive (MI) setting, but its oncological adequacy remains poorly defined. This meta-analysis aims to assess the outcomes of MI-R1v hepatectomy for hepatocellular carcinoma (HCC) and colorectal liver metastases (CLM). PATIENTS AND

methodsA literature search was conducted in MEDLINE, Embase, and Cochrane Library to identify studies reporting local recurrence (LR) rates following MI-R1v for HCC and CLM. Secondary outcomes included the extent of hepatectomy (major versus parenchyma-sparing), tumor burden (monofocal versus multifocal), intrahepatic recurrence, and overall survival (OS).

resultsIn total, eight studies comprising 839 patients (410 HCC and 429 CLM) were included. In HCC, LR rates were comparable between R1v and R0 (5.6% versus 7.9%; odds ratio [OR] 1.2, 95% confidence interval [CI] 0.25-6.1; p = 0.79), whereas in CLM, LR was higher after R1v (12.3% versus 6.4%; OR 3.4, 95% CI 1.10-10.54; p = 0.03). Robotic and laparoscopic R1v resections showed similar LR rates in both HCC (2.8% versus 4.8%; p = 0.82) and CLM (15% versus 12%; p = 0.08). No significant differences were observed between MI-R1v and MI-R0 resections in terms of extent of hepatectomy, tumor burden, intrahepatic recurrence, or OS in either group.

conclusionsThe comparable LR rates suggest that the R1v approach is oncologically acceptable for HCC in the MI setting, supporting its use when R0 cannot be achieved without a major hepatectomy. The higher LR rates in R1v for CLM resections require cautious patient selection and further standardization. Prospective studies are needed to define clear oncological benchmarks for MI-R1v procedures.

Indexed as

Carcinoma, HepatocellularColorectal NeoplasmsHepatectomyLiver NeoplasmsMargins of ExcisionMinimally Invasive Surgical ProceduresHumansNeoplasm Recurrence, LocalPrognosisLiver tumorMinimally invasive surgeryParenchymal-sparing hepatectomyR1 vascular resectionVascular detachment

Identifiers

PMID41507450

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.