Surgical outcomes of laparoscopic versus open hepatectomy for left hepatocellular carcinoma: Propensity score analyses using retrospective Japanese and Korean individual patient data

Autor: Masaki Kaibori, Kengo Yoshii, Yuzo Umeda, Takahito Yagi, Takehiro Okabayashi, Kenta Sui, Akira Mori, Yuhei Hamaguchi, Kiyoshi Kajiyama, Daisuke Hokuto, Kazuteru Monden, Tomoharu Yoshizumi, Yoriko Nomura, Kan Toriguchi, Jong Man Kim, Gi Hong Choi, Je Ho Ryu, Yangseok Koh, Koo Jeong Kang, Young Kyoung You, Kwang-Sik Chun, Young Seok Han, Chan Woo Cho, Young Il Choi, Dong-Sik Kim, Jae Do Yang, Keita Mori, Atsushi Hiraoka, Hiroki Yamaue, Masafumi Nakamura, Masakazu Yamamoto, Itaru Endo
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Liver Cancer (2022)
Druh dokumentu: article
ISSN: 2235-1795
1664-5553
DOI: 10.1159/000527294
Popis: Introduction: This study aimed to compare the prognostic impact of laparoscopic left hepatectomy (LLH) with that of open left hepatectomy (OLH) on patient survival after resection of left hepatocellular carcinoma (HCC). Methods: Among the 953 patients who received initial treatment for primary HCC that was resectable by either LLH or OLH from 2013 to 2017 in Japan and Korea, 146 patients underwent LLH and 807 underwent OLH. The inverse probability of treatment weighting approach based on propensity scoring was used to address the potential selection bias inherent in the recurrence and survival outcomes between the LLH and OLH groups. Results: The occurrence rate of postoperative complications and hepatic decompensation was significantly lower in the LLH group than in the OLH group. Recurrence-free survival (RFS) was better in the LLH group than in the OLH group (hazard ratio, 1.33; 95% confidence interval, 1.03–1.71; p = 0.029), whereas overall survival (OS) were not significantly different. Subgroup analyses of RFS and OS revealed an almost consistent trend in favor of LLH over OLH. In patients with tumor sizes of ≥4.0 cm or those with single tumors, both RFS and OS were significantly better in the LLH group than in the OLH group. Conclusions: LLH decreases the risk of tumor recurrence and improves OS in patients with primary HCC located in the left liver.
Databáze: Directory of Open Access Journals
Externí odkaz: