Long-Term Outcome of Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma: A Case-Controlled Study with Propensity Score Matching

Abstract

The outcome of LR for HCC was technically feasible and safe in selected patients, and LR showed similar perioperative and long-term oncologic outcomes when compared with OR matched with PSM.

Outcomes of Pure Laparoscopic versus Open Hepatic Resection for Hepatocellular Carcinoma in Cirrhotic Patients: A Case-Control Study with Propensity Score Matching

“…As previously mentioned, there have been several studies that compared the long-term outcomes of LH versus OH for HCC [3,4,7,8,27], even in cirrhotic patients [9,12,29]. In addition, in this study, the OS and DFS rates were similar between the two treatment groups.…”

“…PSM offers investigators the ability to balance treated groups across all putative risk factors and allows easy inspection of the achieved balance across measured covariates [28]. To the best of our knowledge, there exists only one study of LH versus OH for cirrhotic patients with HCC using PSM [29]. However, in that report, there were differences in tumor location and type of hepatic resection (anatomical and nonanatomical resection) between the two groups after PSM.…”

“…However, the OS (5-year: 46%) and DFS (3-year: 42%) rates in the LH group in the present study were poor compared with those reported in other studies. The 3- and 5-year OS rates after LH for cirrhotic patients ranged from 67 to 100% and from 76.6 to 92.2%, respectively, whereas the 3- and 5-year DFS rates ranged from 61.7 to 72.6% and from 33 to 54.5% [9,12,29]. These discrepancies can be explained by the shorter mean follow-up period of 34 months and the inclusion of only patients who underwent partial hepatic resection (nonanatomical resection) in our study, whereas other reports included patients who underwent anatomical resection during LH.…”

Long-Term Favorable Surgical Results of Laparoscopic Hepatic Resection for Hepatocellular Carcinoma in Patients with Cirrhosis: A Single-Center Experience over a 10-Year Period

“…32 To minimize the selection biases of Lap-Hx, a case-controlled study with propensity score matching for long-term outcomes of Lap-Hx for HCC was reported. 33 However, in this study, there were originally no significant differences in the patients' background characteristics, operation time, intraoperative blood loss, need for transfusion, or tumor-related factors that could affect the patient prognoses between the 2 groups. Based on our encouraging short-term and long-term results of Lap-Hx for primary HCC within the Milan criteria irrespective of the HCC location in patients with cirrhosis, well-conducted prospective randomized controlled trials with large numbers of patients are needed to confirm our favorable results.…”

The Clinical Significance of Alpha-Fetoprotein mRNAs in Patients with Hepatocellular Carcinoma

“…We therefore reviewed studies that showed the long-term outcomes of laparoscopic hepatectomy versus open hepatectomy: 2 authors showed that laparoscopic hepatectomy offered an advantage in terms of RFS [20,21] , 1 author showed slightly higher RFS at 1-2 years [22] , while the others showed no advantage in terms of RFS [23][24][25] . Unfortunately, there was little information regarding the detailed tumor location or the small number of tumors in segments 7 and 8, which were found to be associated with a high rate of AFP mRNA positivity after open hepatectomy in our study.…”