Laparoscopic versus open limited liver resection for hepatocellular carcinoma with liver cirrhosis: a propensity score matching study with the Hiroshima Surgical study group of Clinical Oncology (HiSCO).

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE
    • Publication Information:
      Publication: 1992- : New York : Springer
      Original Publication: [Berlin] : Springer International, c1987-
    • Subject Terms:
      Propensity Score*; Carcinoma, Hepatocellular/*surgery ; Hepatectomy/*methods ; Laparoscopy/*methods ; Liver Cirrhosis/*surgery ; Liver Neoplasms/*surgery ; Postoperative Complications/*epidemiology; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/diagnosis ; Female ; Humans ; Incidence ; Japan/epidemiology ; Length of Stay ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Neoplasms/complications ; Liver Neoplasms/diagnosis ; Male ; Middle Aged ; Retrospective Studies
    • Abstract:
      Background: Laparoscopic liver resection (LLR) has evolved as a safe and effective alternative to conventional open liver resection (OLR) for malignant lesions. However, LLR in cirrhotic patients remains challenging. This study analyzed the perioperative and oncological outcomes of LLR for hepatocellular carcinoma (HCC) with cirrhosis compared with OLR using propensity score matching.
      Methods: A multicenter retrospective analysis of records of patients who underwent limited liver resection for HCC and were histologically diagnosed with liver cirrhosis between January 2009 and December 2017 in the eight institutions belonging to the Hiroshima Surgical study group of Clinical Oncology was performed. The patients were divided into two groups: the LLR and OLR groups. After propensity score matching, we compared clinicopathological features and outcomes.
      Results: In total 256 patients with histological liver cirrhosis who underwent limited liver resection for HCC were included in this study; 58 patients had undergone LLR, and the remaining 198 patients OLR. The number of tumors was higher, tumor size was larger, and difficulty score was significantly higher in the OLR group before propensity matching. After the matching, the data of the well-matched 58 patients in each group were evaluated; the intraoperative blood loss was lower in the LLR group (p = 0.004), and incidence of the postoperative complications was significantly higher in the OLR group (p = 0.019). The duration of the postoperative hospital stay was significantly shorter in the LLR group (p < 0.001). There were no differences between two groups in overall survival and recurrent-free survival.
      Conclusions: LLR decreased the incidences of postoperative complications, shortened the duration of postoperative hospital stay. Thus, LLR is a safe and feasible procedure even in patients with cirrhosis.
    • Contributed Indexing:
      Keywords: Hepatocellular carcinoma; Laparoscopic liver resection; Limited liver resection; Liver cirrhosis; Multicenter study; Propensity score matching
    • Publication Date:
      Date Created: 20191213 Date Completed: 20210524 Latest Revision: 20210524
    • Publication Date:
      20221213
    • Accession Number:
      10.1007/s00464-019-07302-y
    • Accession Number:
      31828498