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.
Competing Interests: Declaration of competing interest All named authors of this article, including Drs. Meng-Hsuan Chiang, Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang, and Ming-Te Huang, make the following declarations: 1. No support, financial or otherwise, has been received from any organization that may have an interest in the submitted work. 2. There are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2021. Published by Elsevier Taiwan LLC.)