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Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis
BACKGROUND: The differences in short- and long-term outcome between laparoscopic liver resection (LLR) and open liver resection (OLR) for BCLC stage A large hepatocellular carcinoma (HCC) in difficult segments (I, IVa, VII, VIII) remain unclear. This PSM two-centre study aimed to compare perioperati...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038276/ https://www.ncbi.nlm.nih.gov/pubmed/36969010 http://dx.doi.org/10.3389/fonc.2023.1095357 |
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author | Ding, Dong-yang Liu, Lei Lin, Kong-ying Gan, Xiao-jie Guo, Xing-gang Ding, Wen-bin Sun, Da-peng Li, Wen Tao, Qi-fei Gu, Fang-ming Guo, Wei-xing Zeng, Yong-yi Zhou, Wei-ping Yuan, Sheng-xian |
author_facet | Ding, Dong-yang Liu, Lei Lin, Kong-ying Gan, Xiao-jie Guo, Xing-gang Ding, Wen-bin Sun, Da-peng Li, Wen Tao, Qi-fei Gu, Fang-ming Guo, Wei-xing Zeng, Yong-yi Zhou, Wei-ping Yuan, Sheng-xian |
author_sort | Ding, Dong-yang |
collection | PubMed |
description | BACKGROUND: The differences in short- and long-term outcome between laparoscopic liver resection (LLR) and open liver resection (OLR) for BCLC stage A large hepatocellular carcinoma (HCC) in difficult segments (I, IVa, VII, VIII) remain unclear. This PSM two-centre study aimed to compare perioperative and long-term survival outcomes of LLR with OLR for this HCC. METHODS: HCC patients with BCLC stage A who underwent OLR or LLR in two medical centres were enrolled in the study. PSM analysis was performed to match patients between the LLR cohort and OLR cohort. Survival was analysed based on the Kaplan–Meier method. Independent risk factors were identified by Cox regression. RESULTS: After PSM, 35 patients remained in the LLR cohort, and 84 remained in the OLR cohort. Patients in the LLR cohort had more intraoperative blood loss (p=0.036) and shorter hospital stays after surgery (p<0.001). The LLR cohort and OLR cohort had no difference in intraoperative blood transfusion, surgical margin or postoperative short-term outcomes. The OS and RFS were not significantly different between the two cohorts. The OS and RFS of these two cohorts were not different in the subgroup analysis. Surgical margin was identified as an independent risk factor for tumour recurrence. CONCLUSION: For BCLC stage A large HCC patients with lesions in difficult segments, LLR was feasible and had shorter hospital stay than OLR. In addition, a surgical margin ≥1 cm could significantly decrease the recurrence probability for large HCC located in different segments without compromising short-term outcomes. |
format | Online Article Text |
id | pubmed-10038276 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100382762023-03-25 Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis Ding, Dong-yang Liu, Lei Lin, Kong-ying Gan, Xiao-jie Guo, Xing-gang Ding, Wen-bin Sun, Da-peng Li, Wen Tao, Qi-fei Gu, Fang-ming Guo, Wei-xing Zeng, Yong-yi Zhou, Wei-ping Yuan, Sheng-xian Front Oncol Oncology BACKGROUND: The differences in short- and long-term outcome between laparoscopic liver resection (LLR) and open liver resection (OLR) for BCLC stage A large hepatocellular carcinoma (HCC) in difficult segments (I, IVa, VII, VIII) remain unclear. This PSM two-centre study aimed to compare perioperative and long-term survival outcomes of LLR with OLR for this HCC. METHODS: HCC patients with BCLC stage A who underwent OLR or LLR in two medical centres were enrolled in the study. PSM analysis was performed to match patients between the LLR cohort and OLR cohort. Survival was analysed based on the Kaplan–Meier method. Independent risk factors were identified by Cox regression. RESULTS: After PSM, 35 patients remained in the LLR cohort, and 84 remained in the OLR cohort. Patients in the LLR cohort had more intraoperative blood loss (p=0.036) and shorter hospital stays after surgery (p<0.001). The LLR cohort and OLR cohort had no difference in intraoperative blood transfusion, surgical margin or postoperative short-term outcomes. The OS and RFS were not significantly different between the two cohorts. The OS and RFS of these two cohorts were not different in the subgroup analysis. Surgical margin was identified as an independent risk factor for tumour recurrence. CONCLUSION: For BCLC stage A large HCC patients with lesions in difficult segments, LLR was feasible and had shorter hospital stay than OLR. In addition, a surgical margin ≥1 cm could significantly decrease the recurrence probability for large HCC located in different segments without compromising short-term outcomes. Frontiers Media S.A. 2023-03-10 /pmc/articles/PMC10038276/ /pubmed/36969010 http://dx.doi.org/10.3389/fonc.2023.1095357 Text en Copyright © 2023 Ding, Liu, Lin, Gan, Guo, Ding, Sun, Li, Tao, Gu, Guo, Zeng, Zhou and Yuan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Ding, Dong-yang Liu, Lei Lin, Kong-ying Gan, Xiao-jie Guo, Xing-gang Ding, Wen-bin Sun, Da-peng Li, Wen Tao, Qi-fei Gu, Fang-ming Guo, Wei-xing Zeng, Yong-yi Zhou, Wei-ping Yuan, Sheng-xian Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title | Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title_full | Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title_fullStr | Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title_full_unstemmed | Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title_short | Perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for BCLC stage A large hepatocellular carcinoma patients in difficult segments: A two-centre, propensity score matching analysis |
title_sort | perioperative and long-term survival outcomes of laparoscopic versus open hepatectomy for bclc stage a large hepatocellular carcinoma patients in difficult segments: a two-centre, propensity score matching analysis |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038276/ https://www.ncbi.nlm.nih.gov/pubmed/36969010 http://dx.doi.org/10.3389/fonc.2023.1095357 |
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