Hepatocarcinoma Clinical Trial
Official title:
Essai Clinique Pour Une Endomicroscopie Robotisée Dans la redéfinition Des Stratégies d'ExérèsE (PERSÉE) appliquée à la Chirurgie Hépatique
This study aims at assessing the feasibility of Probe-based Confocal Laser Endomicroscopy (pCLE) during laparoscopic hepatic masses resection for intra-operative characterisation of hepatic masses and surgical margins assessment.
Colorectal cancer is the third most common cancer and third leading cause of cancer deaths in
the Western countries. In France, 45.000 new patients develop colorectal cancer every year.
The liver is the most common organ targeted by CRLM, representing 50%. Approximately, 15-25%
of colorectal cancer patients have synchronous CRLM at initial workup, and 20-30% patients
sustain subsequent liver metastases within few years following diagnosis.
The strategy for colorectal cancer liver metastasis resection and liver cancer has evolved to
a parenchymatic sparing procedure. This technic aims to minimize surgical margins width while
removing the tumor. Therefore, the current standard for resection margins is a margin width
superior to 1mm. However, there is still a debate concerning the margin width. Indeed, with
modern chemotherapy, several studies reported no statistical differences in the overall
survival between R0 patients and R1 patients treated with chemotherapy. However, in order to
preserve patients from chemotherapy treatments' adverse effects an intra-operative
microscopic assessment of surgical margins should be set up in order to reduce R1 margins
occurrence.
Ex vivo study:
Surgical specimens obtained during hepatectomy will be imaged to generate an atlas of pCLE
images.
In vivo study:
Intraoperative characterization of sub-capsular hepatic masses and surgical margins will be
assessed.
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