Detailed Abstract
[E-poster]
[E21] Laparoscopic Anatomical Versus Non-anatomical Liver Resection For Hepatocellular Carcinoma Located In The Posterosuperior Segments Of The Liver: A Propensity Score Matched Analysis
Boram LEE1 , Jai Young CHO*1 , Ho-Seong HAN1 , Yoo-Seok YOON1 , Hae Won LEE1 , Jun Suh LEE1 , Moonhwan KIM1 , Yeongsoo JO1
1 Surgery, Seoul National University Bundang Hospital, Seoul National University, REPUBLIC OF KOREA
Background : Anatomical resection for tumors, especially located in the posterosuperior (PS) segments of the liver remains difficult. Usually, laparoscopic non-anatomical resection (LNAR) is preferred for hepatocellular carcinoma (HCC) located in the PS segments.
Methods : We retrospectively reviewed the data for 1029 patients who underwent hepatectomy for HCC between January 2004 and December 2018. Of 167 patients who underwent laparoscopic hepatectomy for HCC in PS segments, 64 underwent LNAR and 103 underwent laparoscopic anatomical resection (LAR). Patient were matched one-to-one using propensity score matching (46:46).
Results : LNAR was associated with significantly shorter operation time (P=0.001), lower estimated blood loss(P=0.001), lower transfusion rate (P=0.006) and shorter hospital stay (P=0.012) than LAR. The respective 1- ,3-, and 5-year overall survival rates (LAR: 95.3, 87.1, and 77.8%; LNAR: 96.7, 91.6, and 85.0%; P=0.262) and recurrence-free survival rates (LAR: 75.7, 70.3, and 68.9%; LNAR: 81.8, 58.3, and 55.3%; P=0.897) were similar in both groups. Recurrence was mostly intrahepatic in the LNAR group and extrahepatic in the LAR group (P=0.023). Post-recurrence treatments differed significantly between the two groups (P=0.016); the re-resection rate was much greater in the LNAR group (45.0% vs. 0%) group. The respective 1-, 3-, and 5-year post-recurrence survival rates were similar in the LAR (78.3%, 49.0%, and 49.0%) and LNAR (92.3%, 79.1%, and 59.3%) groups (P=0.212). After recurrence, survival in re-resection group was significantly greater than not(P = 0.026).
Conclusions : LNAR is safe and feasible for HCC located in PS segments, and provided better short-term outcomes than LAR and acceptable oncological outcomes.
Methods : We retrospectively reviewed the data for 1029 patients who underwent hepatectomy for HCC between January 2004 and December 2018. Of 167 patients who underwent laparoscopic hepatectomy for HCC in PS segments, 64 underwent LNAR and 103 underwent laparoscopic anatomical resection (LAR). Patient were matched one-to-one using propensity score matching (46:46).
Results : LNAR was associated with significantly shorter operation time (P=0.001), lower estimated blood loss(P=0.001), lower transfusion rate (P=0.006) and shorter hospital stay (P=0.012) than LAR. The respective 1- ,3-, and 5-year overall survival rates (LAR: 95.3, 87.1, and 77.8%; LNAR: 96.7, 91.6, and 85.0%; P=0.262) and recurrence-free survival rates (LAR: 75.7, 70.3, and 68.9%; LNAR: 81.8, 58.3, and 55.3%; P=0.897) were similar in both groups. Recurrence was mostly intrahepatic in the LNAR group and extrahepatic in the LAR group (P=0.023). Post-recurrence treatments differed significantly between the two groups (P=0.016); the re-resection rate was much greater in the LNAR group (45.0% vs. 0%) group. The respective 1-, 3-, and 5-year post-recurrence survival rates were similar in the LAR (78.3%, 49.0%, and 49.0%) and LNAR (92.3%, 79.1%, and 59.3%) groups (P=0.212). After recurrence, survival in re-resection group was significantly greater than not(P = 0.026).
Conclusions : LNAR is safe and feasible for HCC located in PS segments, and provided better short-term outcomes than LAR and acceptable oncological outcomes.
SESSION
E-poster
E-Session 12/03 ALL DAY