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Laparoscopic versus open mesohepatectomy for patients with centrally located hepatocellular carcinoma: a propensity score matched analysis

  • Wei Li
  • Jun Han
  • Guowei Xie
  • Yang Xiao
  • Ke Sun
  • Kefei YuanEmail author
  • Hong WuEmail author
Article
  • 51 Downloads

Abstract

Background

Although laparoscopic mesohepatectomy (LM) has been performed for patients with centrally located hepatocellular carcinoma (CL-HCC), its short- and long-term benefits compared with traditional open surgery remain unclear. The aim of the present study was to explore the independent role of LM in the prognosis of patients with CL-HCC.

Methods

A retrospective analysis was undertaken of 348 patients who underwent mesohepatectomy for CL-HCC between January 2012 and October 2017 in our hospital. The impact of the surgical methods on long-term prognosis was evaluated by multivariable regression analysis. In addition, patients in the LM group were matched in a 1:3 ratio with open mesohepatectomy (OM) group.

Results

Some 307 patients underwent OM and 41 had LM. In both adjusted and non-adjusted models, patients in LM group had similar overall survival (OS, both P > 0.05) and disease-free survival (DFS, both P > 0.05) compared to OM patients. The mean (s.d.) OS in LM and OM groups was 41.6 (7.2) and 46.4 (1.4) months, respectively. The mean (s.d.) DFS in LM and OM groups was 37.7 (5.9) and 33.4 (1.5) months, respectively. After propensity score-matched (PSM) analysis, 96 patients remained in OM group and 32 patients in LM group. In the PSM subset, patients in LM group still had comparable OS (P = 0.120) and DFS (P = 0.757) compared to patients in the OM group. After PSM, patients receiving LM had longer vascular exclusion time (P = 0.006) and shorter hospital stay (P = 0.004). In addition, LM was associated with reduced postoperative morbidity after PSM adjustment (P = 0.026).

Conclusions

LM is associated with fewer complications and does not compromise survival compared with OM. LM can be recommended as a safe and reasonable surgical option in selected patients with CL-HCC.

Keywords

Hepatocellular carcinoma Mesohepatectomy Laparoscopy Prognosis 

Notes

Compliance with ethical standards

Disclosures

Drs Wei Li, Jun Han, Guowei Xie, Yang Xiao, Ke Sun, Kefei Yuan, Hong Wu have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2018_6593_MOESM1_ESM.docx (31 kb)
Supplementary material 1 (DOCX 30 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Liver Surgery and Liver Transplantation Centre, West China HospitalSichuan UniversityChengduChina
  2. 2.Department of Critical Care MedicineSichuan Provincial Hospital for Women and ChildrenChengduChina

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