Laparoscopic versus open liver resection for centrally located single hepatocellular carcinoma in cirrhotic patients: A propensity score-matching analysis

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver cancer with poor prognosis, surgery, when feasible, is considered the standard of care. The aim of the study is to compare the peroperative and oncological outcomes of laparoscopic (LLR) and open (OLR) liver resection for centrally located (S5-S8-S4) HCC in cirrhotic patients. Between January 2015 and December 2020 we retrospective analyzed 160 consecutive cirrhotic patients who underwent liver resection for centrally Located (S5-S8-S4) single nodule hepatocellular carcinoma in 8 European Tertiary Center. Patients were divided into LLR and OLR groups and then, perioperative, postoperative and oncological outcomes were analyzed. Patients were matched on age, sex, BMI, ASA score, Child, Meld, size and location of nodule and surgical treatment. After propensity score-matching, 96 patients were enrolled, 48 in the LLR group and 48 in the OLR group. Postoperative overall complications (respiratory complications) were lower in the LCLR than in the OCLR group (2% vs. 18%, P < 0.001). There were no significant differences between the two groups in terms of hospital stay, postoperative mortality (0% in LLR vs. 6% in OLR, P = 0.21), with an increased 90-days mortality (0% vs. 10%, P = 0.05) in OLR. Oncological outcomes were comparable among groups. LLR for single central located HCC in cirrhotic patients is safe and feasible, with lower respiratory complications rate and reduced 90-days mortality.