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

Abstract

Background

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.

Method

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.

Result

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).

Conclusion

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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Acknowledgements

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

Funding

No funding supported for this work.

Author information

Correspondence to Lei Zhang.

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Disclosures

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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Keywords

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