Outcomes of major laparoscopic liver resection for hepatocellular carcinoma

Guro, Hanisah; Cho, Jai Young; Han, Ho‐Seong; Yoon, Yoo Seok; Choi, Young Rok; Kim, Sungho; Kim, Kilhwan; Hyun, In Gun

doi:10.1016/j.suronc.2017.11.006

Cited by 28 publications

(25 citation statements)

References 31 publications

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“…The negative margins and oncologic integrity of the procedure should be obtained, when major laparoscopic liver resection is performed for cancer. No difference in the resection margin was found in the comparative studies of major LLR vs. major OLR, although tumor size of major LLR was large than major OLR in the studies of Goumard [8], Guro [17], Komatsu [18] and Tarantino [20]. In the present case-matched study, the negative margin of major LLR was similar to major OLR.…”

Section: Discussioncontrasting

confidence: 51%

“…As showed in table 3, we have summarized all comparative studies of major LLR vs. major OLR [4][5][6][7][8][17][18][19][20][21][22][23]. The negative margins and oncologic integrity of the procedure should be obtained, when major laparoscopic liver resection is performed for cancer.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the data on perioperative outcomes, major LLR was associated with favorable intraoperative blood loss, total postoperative complications and postoperative hospital stay in the summarized comparative studies. However, the operation time of major LLR was significantly longer than major OLR in most of the retrospective studies [4][5][6][7][8][17][18][19]21,22]. Recently, the Japanese National Clinical Database showed that major LLR was associated with less blood loss, a lower complication rate and shorter hospital stay comparing with major OLR [26].…”

Section: Discussionmentioning

confidence: 99%

“…The second International Consensus Conference of Morioka recommended that LMH comprised innovative procedures in the exploration phase and could only be performed in those with experience of major open liver resections and advanced laparoscopic techniques [4]. With accumulating the development of new instruments, the introduction of novel techniques, the improvements in surgical skills and experience of LLR, some recent studies reported that LMH and OMH had similar oncologic outcomes in patients with hepatocellular carcinoma (HCC) [5][6][7][8]. However, just a few studies described the long-term oncologic outcomes of LMH for HCC.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Wang

et al. 2020

Preprint

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Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Wang

et al. 2020

Preprint

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“…In this work anatomical resection emerged as a good prognostic factor for HCC recurrence, but had no impact on the OS. Another recent study by Guro et al [29] considered retrospectively 177 patients who underwent major LLR or OLR, finding the early (< 1 year) recurrence rate to be significantly higher in the open group, with similar OS and DFS rates. Population in this study also showed a larger tumor size in the open group, which could explain the better results in the laparoscopic one.…”

Section: Oncological Outcomesmentioning

confidence: 95%

Laparoscopic liver resection for hepatocellular carcinoma

Giacca¹,

Cherqui²

2018

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Hepatocellular carcinoma (HCC) represents the most common indication of laparoscopic liver resection (LLR). It must be acknowledged that most series concern minor hepatectomies for peripheral lesions located in favorable segments, and such procedures are now performed in the majority of HPB centers. However, there are growing reports concerning major hepatectomies (i.e., 3 segments or more) and complex resections such as anatomical resections in difficult segments (i.e., postero-superior). Retrospective comparative studies, including some with propensity score matching, and meta-analyses showed that LLR is associated with short-term benefits including reduced blood loss, length of stay and morbidity with identical oncological results and survival rates. In addition, laparoscopy leads to less post-operative abdominal adhesions, improving operative outcomes in case of repeat hepatectomy or secondary liver transplantation. Despite the lack of results of randomized-controlled trials in HCC, a consensus exists that the laparoscopic approach can improve the outcome of major liver resections, provided it is performed in experienced centers. This requires specific high-quality training.

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Long‐term outcomes of laparoscopic versus open liver resection for intrahepatic combined hepatocellular‐cholangiocarcinoma with propensity score matching

Lee

Choi

Lee

et al. 2022

Annals of Gastroent Surgery

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Background Combined hepatocellular‐cholangiocarcinoma (cHCC‐CCA) is a rare primary hepatic neoplasm. Currently, there are no well‐structured studies that analyze the feasibility of laparoscopic liver resection in cHCC‐CCA alone. This retrospective cohort study aimed to compare the long‐term survival of laparoscopic liver resection with open liver resection in cHCC‐CCA. Methods Patients with a postoperative pathologic report of cHCC‐CCA who underwent liver resection from August 2004 to December 2017 were included in this study. Kaplan–Meier survival analysis was performed to analyze the 3‐y disease‐free survival and 3‐y overall survival. Propensity score matching was done to reduce the influence of confounding variables. Results A total of 145 patients were pathologically confirmed to have cHCC‐CCA, of which 10 patients were excluded due to having received palliative surgery. Of the remaining 135 patients, 43 underwent laparoscopic and 92 underwent open liver resection; propensity score matching yielded 30 patients for each group. The 3‐y overall survival was 38 (88.4%) in the laparoscopic group and 84 (91.3%) in the open group before propensity score matching (P = .678), and 25 (83.3%) and 28 (93.3%), respectively, after matching (P = .257). The 3‐y disease‐free survival was 24 (55.8%) in the laparoscopic group and 32 (34.8%) in the open group before matching (P = .040), and 17 (56.7%) and 16 (53.3%), respectively, after matching (P = .958). The hospital stay was shorter in the laparoscopic group before and after matching, while other operative outcomes were similar in both groups. Conclusion Laparoscopic liver resection for cHCC‐CCA is technically feasible and safe, having a shorter hospital stay without compromising oncological outcomes.

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Outcomes of major laparoscopic liver resection for hepatocellular carcinoma

Cited by 28 publications

References 31 publications

Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Laparoscopic liver resection for hepatocellular carcinoma

Long‐term outcomes of laparoscopic versus open liver resection for intrahepatic combined hepatocellular‐cholangiocarcinoma with propensity score matching

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