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Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study



Liver re-resection plays a paramount role in treatment of patients with posthepatectomy hepatocellular carcinoma (HCC) recurrence. Laparoscopic liver resection has been a feasible alternative to open surgery. However, whether laparoscopic liver re-resection for posthepatectomy HCC recurrence is better than open liver re-resection remains unknown.


From January 2008 to December 2015, 30 patients with recurrent HCC after prior liver resection underwent laparoscopic liver re-resection in our center. To minimize any confounding factors, a propensity score matching study using a patient ratio of 1:1 was conducted to compare the short- and long-term outcomes of patients who underwent laparoscopic or open liver re-resection.


With the open surgery group compared laparoscopic group, operative time was 207.50 versus 200.5 min (p = 0.903), blood loss was 400 versus 100 ml (p = 0.000196), blood transfusion rate was 43.3 versus 0.0% (p = 0.000046), complication rates were 30.0 versus 6.7% (p = 0.01), and hospital stay was 13.5 versus 9.5 days (p = 0.000008). The median follow-up was 35 months. The 1-year, 3-year, 5-year disease-free survival rates were 79.0, 51.0, and 31.9%, versus 78.3, 57.4, and 43.0%, respectively (p = 0.474). The 1-year, 3-year, and 5-year overall survival rates were 89.4, 75, and 67.5%, versus 96.7, 85.0, and 74.4%, respectively (p = 0.413).


Laparoscopic liver re-resection for patients with posthepatectomy HCC recurrence provided comparable perioperative and oncological outcomes as open liver re-resection and can be a safe alternative to open procedure.

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We are grateful to Wan Yee Lau, The Chinese University of Hong Kong, for writing assistance and review of our manuscript.


No funding supported for this work.

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Correspondence to Lei Zhang.

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Dr. Kairui Liu; Dr. Yajin Chen; Dr. Xiaolin Wu; Dr. Zejian Huang; Dr. Zeyu Lin; Dr. Junliang Jiang; Dr. Wenliang Tan; Dr. Lei Zhang have no conflicts of interest or financial ties to disclose.

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Liu, K., Chen, Y., Wu, X. et al. Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study. Surg Endosc 31, 4790–4798 (2017). https://doi.org/10.1007/s00464-017-5556-3

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  • Posthepatectomy hepatocellular recurrence
  • Laparoscopic liver re-resection
  • Short-term outcomes
  • Survival analysis