Recurrence of Liver Hydatid Cyst and Predictive Factors

Abstract

Purpose: Hydatid cyst is a zoonotic disease which leads to cyst formation commonly into the liver. Despite advances in surgical techniques and the medical treatment, the relapse is the major problem in the management of hydatid disease. The recurrence described rate in the literature is variable (0-22%). The aim of this study was to determine the hydatid cyst recurrence, and the risk factors involved in that. Moreover, we studied the treatment applied to these patients. Methods: A descriptive retrospective study has been carried out. We review all patients operated on with hydatid cyst between 2006-2020. The minimum follow-up time was six months. Regression models for multivariate analysis were made to investigate risk factors of recurrence. Results: 279 patients were included in the study. Out of 149 were men (53.4%) and with an average age of 51.29 years (DS+/-14.7). 54 patients (19.4%) had a history of previous hepatic or pulmonary hydatidosis. 104 (37.3%) had a complicated cyst. Radical surgery was performed in 164 patients (58.8%). The recurrence rate is 6.1% (17 patients). The most frequent type of recurrence is hepatic, 14 (82.4%). Among the patients who had a recurrence, 8 were re-operated. The median time to relapse was 44 months (IQR 20-79.25). The risk factors related to recurrence to having a previous recurrence, symptomatic cyst at diagnosis, CE3-5 cyst, more than two cysts and partial cystectomy. In the multivariate analyses, only CE3-5 cyst (p=0.064) and to having more than two cysts (p=0.029), were related with more risk of recurrence Conclusion: Different risk factors of recurrence have been described in the literature. In our series, we observed that to having multiple cysts and the WHO classification CE3-5 are related to a higher risk of recurrence. We have not found a higher risk according to the type of surgery.