Cancers, Vol. 13, Pages 4800: Minimally Invasive versus Open Liver Resection for Stage I/II Hepatocellular Carcinoma

Cancers, Vol. 13, Pages 4800: Minimally Invasive versus Open Liver Resection for Stage I/II Hepatocellular Carcinoma Cancers doi: 10.3390/cancers13194800 Authors: Emrullah Birgin Sarah R. Kaslow Svetlana Hetjens Camilo Correa-Gallego Nuh N. Rahbari Minimally invasive liver resection (MILR) is increasingly used as a surgical treatment for patients with hepatocellular carcinoma (HCC). However, there is no large scale data to compare the effectiveness of MILR in comparison to open liver resection (OLR). We identified patients with stage I or II HCC from the National Cancer Database using propensity score matching techniques. Overall, 1931 (66%) and 995 (34%) patients underwent OLR or MILR between 2010 and 2015. After propensity matching, 5-year OS was similar in the MILR and OLR group (51.7% vs. 52.8%, p = 0.766). MILR was associated with lower 90-day mortality (5% vs. 7%, p = 0.041) and shorter length of stay (4 days vs. 5 days, p < 0.001), but higher rates of positive margins (6% vs. 4%, p = 0.001). An operation at an academic institution was identified as an independent preventive factor for a positive resection margin (OR 0.64: 95% CI 0.43–0.97) and 90-day mortality (OR 0.61; 95% CI 0.41–0.91). MILR for HCC is associated with similar overall survival to OLR, with the benefit of improved short term postoperative outcomes. The increased rate of positive margins after MILR requires further investigation, as do the differences in perioperative outc...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research