Short- and long-term outcomes of laparoscopic versus open liver resection for large hepatocellular carcinoma: a propensity score study

• DOI: 10.1007/s00595-022-02576-7
• Publication Date: 2022-08-20T04:02:32Z
• Authors: Kang-Jun Zhang; Lei Liang; Yong-Kang Diao; Ya-Ming Xie; Dong-Dong Wang; Fei-Qi Xu; Tai-Wei Ye; Wen-Feng Lu; Jian Cheng; Guo-Liang Shen; Wei-Feng Yao; Yi Lu; Zun-Qiang Xiao; Jun-Gang Zhang; Cheng-Wu Zhang; Dong-Sheng Huang; Jun-Wei Liu
• Keywords: 03 medical and health sciences; Carcinoma, Hepatocellular; 0302 clinical medicine; Liver Neoplasms; Humans; Hepatectomy; Laparoscopy; Length of Stay; Propensity Score; Retrospective Studies

Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) remains controversial, especially for tumors larger than 5 cm. We compared the short- and long-term outcomes of laparoscopic and open liver resection (OLR) for large HCC.Patients with large HCC after curative hepatectomy were enrolled. To compare the short-term outcomes, propensity score matching (PSM) and inverse probability treatment weighting (IPTW) were performed to reduce the effect of confounding factors, respectively. Subsequently, Cox-regression analyses were conducted to identify the independent risk factors associated with decreased recurrence-free survival (RFS) and poor overall survival (OS).There were 265 patients enrolled in the final analysis: 146 who underwent OLR and 119 who underwent LLR. There was no significant difference between the OLR and LLR groups according to PSM and IPTW analysis (all P > 0.05). Multivariable analysis revealed that LLR was not independently associated with poorer OS (HR 1.15, 95% CI 0.80-1.67, P = 0.448) or RFS (HR 1.22, 95% CI 0.88-1.70, P = 0.238).There were no significant differences in perioperative complications or long-term prognosis between LLR and OLR for large HCC, which provides evidence for standard laparoscopic surgical practice with adequate surgeon experience and careful patient selection.