Comparison of surgical outcomes for laparoscopic liver resection of large hepatocellular carcinomas: A retrospective observation from single-center experience

Background/purpose: Although laparoscopic liver resection (LLR) is a common surgical procedure for hepatocellular carcinoma (HCC), its suitability for large HCCs (>5 cm) remains controversial. This study compared surgical outcomes of open hepatectomy with LLR for large HCCs. Methods: A total of 313 patients with HCC who underwent hepatectomy between January 2010 and June 2017 were analyzed retrospectively. Demographic data, short-term outcomes, and long-term survivals were analyzed. Results: Among patients with large HCCs (n = 122), the open group (n = 85) had larger tumor sizes (10.91 +/- 4.72 vs. 7.45 +/- 2.95 cm; p < 0.001) and more advanced stages (stages 3/4: 71.8% vs. 45.9%; p = 0.029) than the LLR group (n = 37), while LLR group achieved less blood loss (623.24 +/- 841.75 mL vs. 1091.76 +/- 1004.72 mL, p = 0.014) and shorter LOS (9.00 +/- 5.13 d vs. 12.82 +/- 8.51 d, p = 0.013). There were no significant differences in complication and mortality rates between groups. The 5-year overall and recurrence-free survival rates between the two groups were not significantly different (p = 0.408 and 0.644 respectively). The surgical outcomes showed equal benefit of the two operation types. Conclusion: With sufficient surgeon experience and appropriate patient selection, LLR is a feasible treatment choice for large HCCs. (c) 2021 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).