Transatlantic registries for minimally invasive liver surgery: towards harmonization

Area of Science:

• Hepatobiliary Surgery
• Surgical Registries
• Minimally Invasive Surgery

Background:

• Multiple registries collect data on patients undergoing minimally invasive liver surgery (MILS).
• Transatlantic registries exhibit variations in collected variables, patient characteristics, indications, and treatments for MILS.
• Identifying key variables is essential for comparative analysis.

Purpose of the Study:

• To compare transatlantic registries for liver surgery based on collected variables.
• To identify differences in baseline characteristics, indications, and treatment for MILS patients.
• To establish a consensus on key variables for MILS research.

Main Methods:

• Five liver surgery registries (North America, Italy, Norway, Netherlands, Europe) were compared.
• Key variables were established by expert consensus and compared across registries.
• Anonymized MILS data (January 2014-December 2019) were analyzed, presenting largest differences (RLD, ALD) in patient characteristics, treatment, and outcomes.

Main Results:

• 13,571 MILS patients were included; 30- and 90-day mortality were consistently below 1.1%.
• Significant variations observed in ASA grade 3-4 (RLD 3.0) and liver cirrhosis (RLD 6.4).
• Neoadjuvant chemotherapy use varied (RLD 4.3); collected variables ranged from 28 to 303, with 34 key variables missing in at least one registry.

Conclusions:

• Despite variations in patient data and treatment, MILS demonstrates consistently low mortality (<1.1%) across registries.
• Harmonization of MILS registries is recommended to enable future collaborative research.
• The identified 46 key variables are instrumental for standardizing MILS data collection and analysis.