Laparoscopic versus open limited liver resection for hepatocellular carcinoma with liver cirrhosis: a propensity score m
- PDF / 714,289 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 47 Downloads / 280 Views
and Other Interventional Techniques
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) Masateru Yamamoto1 · Tsuyoshi Kobayashi1 · Akihiko Oshita2 · Tomoyuki Abe3 · Toshihiko Kohashi4 · Takashi Onoe5 · Saburo Fukuda6 · Ichiro Omori7 · Yasuhiro Imaoka8 · Naruhiko Honmyo1 · Hideki Ohdan1 Received: 11 July 2019 / Accepted: 28 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
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 1) Tumor size (mm) Difficulty score
71 (34–89) 39/19 23.4 (15.6–37.1) 30/25 25 (45.4) 10 (17.2) 32 (55.2) 81 (51–116) 0.8 (0.2–2.9) 49 (11–165) 31 (10–198) 3.7 (2.5–4.9) 22.4 (2.2–63.1) 10.2 (1.7–4188) 34 (12–6980) 45/13 28/30 48/10 17 (1.2–42) 3 (1–6)
68 (45–88) 123/74 23.5 (15.2–41.5) 125/66 66 (34.6) 33 (16.8) 123 (62.4) 80 (13–116) 0.9 (0.3–2.4) 39 (13–180) 28 (8–172) 3.7 (2.4–4.9) 22.3 (2.9–59.7) 10.8 (1–12,772) 45 (8–17,431) 166/32 93/98 134/64 20 (7–99) 3 (1–8)
0.201 0.538 0.987 0.155 1 0.359 0.678 0.928 0.243 0.219 0.601 0.531 0.865 0.511 0.316 0.326 0.191 0.032 0.006 0.045
Values are median (range) unless otherwise indicated AFP alpha-fetoprotein levels, Alb albumin, AST asparate aminotransferase, ALT alanine aminotransferase, BMI body mass index, DCP des-gamma-carboxyprothorombin, DM diabetes mellitus, HBV hepatitis B virus, HCV hepatitis C virus, ICGR15 indocyanine green retention rate at 15 min
Data Loading...
