Minimally invasive versus open liver resection for hepatocellular carcinoma with microvascular invasion: a propensity score-matching study.

IF 2.4 2区医学 Q2 SURGERY

Surgical Endoscopy And Other Interventional Techniques Pub Date : 2025-06-01 Epub Date: 2025-04-18 DOI:10.1007/s00464-025-11717-1

Zaibo Yang, Yewei Zhang, Junhao Zheng, Liye Tao, Chao Song, Linghan Gong, Renan Jin, Xiao Liang

{"title":"Minimally invasive versus open liver resection for hepatocellular carcinoma with microvascular invasion: a propensity score-matching study.","authors":"Zaibo Yang, Yewei Zhang, Junhao Zheng, Liye Tao, Chao Song, Linghan Gong, Renan Jin, Xiao Liang","doi":"10.1007/s00464-025-11717-1","DOIUrl":null,"url":null,"abstract":"Background: Microvascular invasion (MVI) is one of the major risk factors for postoperative recurrence of HCC. For HCC patients with MVI, few studies have examined the differences in prognosis between minimally invasive and open liver resection.Materials and methods: A total of 171 HCC patients with MVI who underwent curative-intent hepatectomy from September 2017 to October 2022 at Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, were enrolled in this study. Patients were categorized into minimally invasive liver resection (MILR) group (Robotic or laparoscopic) and open liver resection (OLR) group. In order to balance the baseline characteristics between the two groups, 1:4 propensity score matching (PSM) was performed on the two groups. The survival parameters and perioperative parameters were compared between the two groups before and after PSM, respectively.Results: There was no significant difference in Recurrence Free Survival (RFS) and Overall Survival (OS) between the two groups before and after PSM. Subgroup analysis showed that there were no significant differences in OS and RFS between the two groups regarding anatomical resection, IWATE difficulty score, surgical margins, and postoperative adjuvant therapy. Perioperative parameters and the rate of major postoperative complications were comparable between the two groups.Conclusion: Minimally invasive approach can provide a comparable long-term survival result compared with conventional open approach for patients with HCC associated with MVI.","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3492-3503"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Endoscopy And Other Interventional Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00464-025-11717-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Microvascular invasion (MVI) is one of the major risk factors for postoperative recurrence of HCC. For HCC patients with MVI, few studies have examined the differences in prognosis between minimally invasive and open liver resection.

Materials and methods: A total of 171 HCC patients with MVI who underwent curative-intent hepatectomy from September 2017 to October 2022 at Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, were enrolled in this study. Patients were categorized into minimally invasive liver resection (MILR) group (Robotic or laparoscopic) and open liver resection (OLR) group. In order to balance the baseline characteristics between the two groups, 1:4 propensity score matching (PSM) was performed on the two groups. The survival parameters and perioperative parameters were compared between the two groups before and after PSM, respectively.

Results: There was no significant difference in Recurrence Free Survival (RFS) and Overall Survival (OS) between the two groups before and after PSM. Subgroup analysis showed that there were no significant differences in OS and RFS between the two groups regarding anatomical resection, IWATE difficulty score, surgical margins, and postoperative adjuvant therapy. Perioperative parameters and the rate of major postoperative complications were comparable between the two groups.

Conclusion: Minimally invasive approach can provide a comparable long-term survival result compared with conventional open approach for patients with HCC associated with MVI.

查看原文本刊更多论文

微创与开放肝切除术治疗伴有微血管侵犯的肝细胞癌：倾向评分匹配研究。

背景：微血管侵犯是HCC术后复发的主要危险因素之一。对于合并MVI的HCC患者，很少有研究探讨微创和开放肝切除术在预后上的差异。材料与方法：本研究纳入2017年9月至2022年10月在浙江大学医学院邵逸夫爵士医院行有意治愈肝切除术的171例肝癌合并MVI患者。将患者分为微创肝切除术（MILR）组（机器人或腹腔镜）和开放肝切除术（OLR）组。为了平衡两组之间的基线特征，对两组进行1:4倾向评分匹配（PSM）。比较两组患者PSM前后的生存参数和围手术期参数。结果：两组患者PSM前后无复发生存期（RFS）和总生存期（OS）比较，差异均无统计学意义。亚组分析显示，两组在解剖切除、IWATE难度评分、手术切缘和术后辅助治疗方面的OS和RFS无显著差异。两组围手术期参数和术后主要并发症发生率比较，差异无统计学意义。结论：对于肝细胞癌合并MVI患者，微创入路可提供与传统开放入路相当的长期生存结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Surgical Endoscopy And Other Interventional Techniques 医学-外科

CiteScore

6.10

自引率

12.90%

发文量

890

审稿时长

6 months

期刊介绍： Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research. Topics covered in the journal include: -Surgical aspects of: Interventional endoscopy, Ultrasound, Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology, -Gastroenterologic surgery -Thoracic surgery -Traumatic surgery -Orthopedic surgery -Pediatric surgery