1. Laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: a propensity score matching analysis
- Author
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Maria Conticchio, Francesca Ratti, Giulio Cesare Vitali, Taiga Wakabayashi, Paolo Magistri, Valentina Ferraro, Giacomo Assirati, Fabrizio Di Benedetto, Tullio Piardi, Umberto Riccelli, Emanuele Felli, Javier Briceño-Delgado, Alexis Laurent, Nicola de’Angelis, Patrick Pessaux, Daniel Cherqui, Ferdinando M. Anelli, Riccardo Memeo, Antonella Delvecchio, René Adam, Maximiliano Gelli, Luca Aldrighetti, Delvecchio, A., Conticchio, M., Riccelli, U., Ferraro, V., Ratti, F., Gelli, M., Anelli, F. M., Laurent, A., Vitali, G. C., Magistri, P., Assirati, G., Felli, E., Wakabayashi, T., Pessaux, P., Piardi, T., Di Benedetto, F., De'Angelis, N., Briceno-Delgado, J., Adam, R., Cherqui, D., Aldrighetti, L., and Memeo, R.
- Subjects
medicine.medical_specialty ,Carcinoma, Hepatocellular ,Resection ,Postoperative Complications ,Overall survival ,Medicine ,Hepatectomy ,Humans ,In patient ,Propensity Score ,Aged ,Retrospective Studies ,Open liver resection ,Hepatology ,business.industry ,Liver Neoplasms ,Gastroenterology ,Perioperative ,Length of Stay ,medicine.disease ,Surgery ,Treatment Outcome ,Hepatocellular carcinoma ,Propensity score matching ,Matched group ,Laparoscopy ,business - Abstract
Background: Surgical resection is a first-line curative option for hepatocellular carcinoma, but its role is still unclear in elderly patients. The aim of our study was to compare short- and long-term outcomes of laparoscopic and open liver resection in elderly patients with hepatocellular carcinoma. Methods: The study included 665 consecutive hepatocellular carcinoma liver resection cases in patients with ≥70 years of age treated in eight European hospital centres. Patients were divided into laparoscopic and open liver resection groups. Perioperative and long-term outcomes were compared between these groups. Results: After a 1:1 propensity score matching, 219 patients were included in each group. Clavien-Dindo grades III/IV (6 vs. 20%, p = 0.04) were lower in the laparoscopic than in the open matched group. Hospital stay was shorter in the laparoscopic than in the open matched group (5 vs. 7 days, p < 0.001). There were no significant differences between laparoscopic and open groups regarding overall survival and disease-free survival at 1-, 3- and 5- year periods. Conclusion: Laparoscopic liver resection for hepatocellular carcinoma is associated with good short-term outcomes in patients with ≥70 years of age compared to open liver resection. Laparoscopic liver resection is safe and feasible in elderly patients with hepatocellular carcinoma.
- Published
- 2021