Comparative study of propensity score matching method and benchmark article method on the outcomes of laparoscopic major liver and open major liver resection for hepatocellular carcinoma

Abstract

Background: To compare the outcomes of major laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma (HCC) with two methods. Methods: We retrospectively reviewed a data of 177 patients who underwent major liver resection for HCC (LLR; n = 67 vs. OLR; n = 110). We performed 1:1 propensity score matching (PSM) between two groups and matched 65 patients for both groups. Another comparison was done with already published article as a benchmark after applying similar inclusion and exclusion criteria (LLR; n = 30 vs. OLR; n = 34). Results: After PSM, there were no significant differences in blood loss (1,407.2 ± 2,322.7 vs. 1,071.5 ± 1,160.6 mL; p = 0.299), and transfusion rate (32.2% vs. 32.0%; p = 0.574) between two groups. The mean operative time was significantly longer in LLR than in the OLR group (418.7 ± 172 vs. 335.1 ± 121.6 min; p = 0.002). Complication rate (21.5% vs. 33.8%; p = 0.085) was similar and the mean hospital stay was shorter in the LLR than in the OLR group (11.4 ± 8.5 vs. 17.6 ± 21.4 days; p = 0.009). After benchmarking method, there were no significant differences in between two groups in terms of blood loss (780 ± 822 vs. 947 ± 660.5 mL; p = 0.382), transfusion rate (30.0 vs. 32.4%; p = 0.528), hospital stay (9 ± 3.7 vs. 10.4 ± 3.59 days; p = 0.119), and complication rate (10.0% vs. 20.6%; p = 0.208). Operation time (395 ± 166.6 vs. 296 ± 68.3 min; p = 0.002) was significantly longer in the LLR than in the OLR group. Benchmarking method showed significant loss of number of patients analysed, but results were quite similar to PSM method. Conclusions: Both methods showed that major LLR was safe compared to major OLR. Benchmarking method can be easily used to compare with data of other published article.