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Laparoscopic versus open liver resection for resectable HCC with BCLC stage B: a propensity score-matched analysis

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Abstract

To date, there is little knowledge about the value of laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) patients with Barcelona Clinic Liver Cancer (BCLC) stage B. Thus, this study was performed to assess the perioperative and oncological outcomes of LLR for these patients by comparison with open liver resection (OLR). Between April 2015 and October 2018, a total of 217 resectable HCC patients with BCLC stage B were eligible for this study. Patients were divided into the LLR group and the OLR group according to different procedures. Propensity score matching (PSM) was conducted to adjust for known confounders. Short- and long-term outcomes were compared between the two groups. LLR was performed in 75 of the 217 included patients. After PSM, 72 patients with well-balanced baseline levels were enrolled into each group. Although the operative time was significantly longer in the LLR group than in the OLR group (median, 237.5 vs. 210 min, P = 0.024), the intraoperative blood loss was significantly less in the LLR group than in the OLR group (median, 200 vs. 350 ml, P = 0.005). Patients in the LLR group had fewer complications than those in the OLR group (P = 0.035). Furthermore, overall survival (OS, P = 0.827) and recurrence-free survival (RFS, P = 0.694) were comparable between the two groups. LLR for resectable HCC patients with BCLC stage B is safe and feasible in carefully selected patients and has superior perioperative outcomes and similar survival rates compared with OLR.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (Nos. 81602910, 81302344, and 81802095) and the Sichuan Science and Technology Program (Nos. 2019YFS0370, 2019YFS0372, and 2017FZ0043).

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Author notes

  1. Yufu Peng and Kefei Chen have contributed equally to this study and share first authorship.

Authors and Affiliations

  1. Department of Liver Surgery, Center of Liver Transplantation, West China Hospital of Sichuan University, No. 37 Guoxuexiang, Chengdu, Sichuan Province, China

    Yufu Peng, Kefei Chen, Bo Li, Hongwei Xu, Yonggang Wei & Fei Liu

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  1. Yufu Peng
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  2. Kefei Chen
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  3. Bo Li
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  4. Hongwei Xu
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Correspondence to Yonggang Wei or Fei Liu.

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Ethical approval and Informed consent

This study was conducted in accordance with the principles of the Declaration of Helsinki and a written informed consent was obtained from all participants. The study was approved by the Ethics Committee of West China Hospital of Sichuan University.

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This article does not contain any studies with human participants performed by any of the authors (retrospective study).

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Peng, Y., Chen, K., Li, B. et al. Laparoscopic versus open liver resection for resectable HCC with BCLC stage B: a propensity score-matched analysis. Updates Surg 74, 1291–1297 (2022). https://doi.org/10.1007/s13304-022-01309-2

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