肝细胞癌右后路微创切除术的标准化技术：倾向评分匹配研究。

IF 1.7 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2025-08-01 DOI:10.21873/anticanres.17711

Hisamune Sakai, Yuichi Goto, Shogo Fukutomi, Shoichirou Arai, Ryuta Midorikawa, Kazuaki Hashimoto, Daiki Miyazaki, Masanori Akashi, Nobuya Ishibashi, Koji Okuda, Fumihiko Fujita, Toru Hisaka

{"title":"肝细胞癌右后路微创切除术的标准化技术：倾向评分匹配研究。","authors":"Hisamune Sakai, Yuichi Goto, Shogo Fukutomi, Shoichirou Arai, Ryuta Midorikawa, Kazuaki Hashimoto, Daiki Miyazaki, Masanori Akashi, Nobuya Ishibashi, Koji Okuda, Fumihiko Fujita, Toru Hisaka","doi":"10.21873/anticanres.17711","DOIUrl":null,"url":null,"abstract":"Background/aim: Minimally invasive right posterior sectionectomy (MIRPS) for hepatocellular carcinoma (HCC) is a technically demanding anatomical liver resection procedure, characterized by restricted visibility and complex hemostatic control. Its effectiveness, compared to that of open surgery, is uncertain. Therefore, this study aimed to compare the perioperative and long-term oncological outcomes of MIRPS and open right posterior sectionectomy (ORPS) for HCC.Patients and methods: Data of 122 consecutive patients, who underwent right posterior sectionectomy as initial treatment for primary HCC from January 2010 to February 2025, were retrospectively analyzed. Patients were allocated to MIRPS and ORPS groups, and surgical outcomes were compared using 1:1 propensity score matching (PSM).Results: After PSM, the MIRPS and ORPS groups comprised 35 patients each. No procedures in the MIRPS group required conversion to open surgery. The MIRPS group demonstrated significantly lower blood loss (119 vs. 548 ml; p<0.0001), reduced transfusion rates (0% vs. 11.4%; p=0.0394), shorter operative durations (356 vs. 396 min; p=0.0376), lower postoperative morbidity rates (0% vs. 28.6%; p=0.0006), and shorter postoperative hospital stays (9 vs. 15 days; p<0.0001) compared to the ORPS group. The 1-, 3-, and 5-year overall survival rates were 100%, 96.3%, and 96.3% in the MIRPS group and 100%, 91.2%, and 87.9%, in the ORPS group (p=0.3026), respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 88.5%, 77.1%, and 71.6% in the MIRPS group and 85.7%, 65.4%, and 65.4%, in the ORPS group (p=0.5631), respectively.Conclusion: MIRPS reduced perioperative complications, shortened postoperative hospital stay, and achieved recurrence-free and overall survival rates comparable to those of ORPS. Our standardized MIRPS procedure for HCC is considered safe, feasible, and oncologically acceptable for use in selected patients.","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 8","pages":"3497-3510"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Standardized Technique for Minimally Invasive Right Posterior Sectionectomy for Hepatocellular Carcinoma: A Propensity Score-matched Study.\",\"authors\":\"Hisamune Sakai, Yuichi Goto, Shogo Fukutomi, Shoichirou Arai, Ryuta Midorikawa, Kazuaki Hashimoto, Daiki Miyazaki, Masanori Akashi, Nobuya Ishibashi, Koji Okuda, Fumihiko Fujita, Toru Hisaka\",\"doi\":\"10.21873/anticanres.17711\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background/aim: Minimally invasive right posterior sectionectomy (MIRPS) for hepatocellular carcinoma (HCC) is a technically demanding anatomical liver resection procedure, characterized by restricted visibility and complex hemostatic control. Its effectiveness, compared to that of open surgery, is uncertain. Therefore, this study aimed to compare the perioperative and long-term oncological outcomes of MIRPS and open right posterior sectionectomy (ORPS) for HCC.Patients and methods: Data of 122 consecutive patients, who underwent right posterior sectionectomy as initial treatment for primary HCC from January 2010 to February 2025, were retrospectively analyzed. Patients were allocated to MIRPS and ORPS groups, and surgical outcomes were compared using 1:1 propensity score matching (PSM).Results: After PSM, the MIRPS and ORPS groups comprised 35 patients each. No procedures in the MIRPS group required conversion to open surgery. The MIRPS group demonstrated significantly lower blood loss (119 vs. 548 ml; p<0.0001), reduced transfusion rates (0% vs. 11.4%; p=0.0394), shorter operative durations (356 vs. 396 min; p=0.0376), lower postoperative morbidity rates (0% vs. 28.6%; p=0.0006), and shorter postoperative hospital stays (9 vs. 15 days; p<0.0001) compared to the ORPS group. The 1-, 3-, and 5-year overall survival rates were 100%, 96.3%, and 96.3% in the MIRPS group and 100%, 91.2%, and 87.9%, in the ORPS group (p=0.3026), respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 88.5%, 77.1%, and 71.6% in the MIRPS group and 85.7%, 65.4%, and 65.4%, in the ORPS group (p=0.5631), respectively.Conclusion: MIRPS reduced perioperative complications, shortened postoperative hospital stay, and achieved recurrence-free and overall survival rates comparable to those of ORPS. Our standardized MIRPS procedure for HCC is considered safe, feasible, and oncologically acceptable for use in selected patients.\",\"PeriodicalId\":8072,\"journal\":{\"name\":\"Anticancer research\",\"volume\":\"45 8\",\"pages\":\"3497-3510\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anticancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/anticanres.17711\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17711","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景/目的：微创右后切开术（MIRPS）治疗肝细胞癌（HCC）是一项技术要求很高的解剖性肝切除手术，其特点是能见度受限和止血控制复杂。与开放手术相比，其有效性尚不确定。因此，本研究旨在比较MIRPS和开放式右后路切除术（ORPS）治疗HCC的围手术期和长期肿瘤预后。患者和方法：回顾性分析2010年1月至2025年2月连续122例接受右侧后切断术作为原发性HCC初始治疗的患者的资料。将患者分为MIRPS组和ORPS组，采用1:1倾向评分匹配（PSM）对手术结果进行比较。结果：经PSM后，MIRPS组和ORPS组各35例。MIRPS组中没有手术需要转为开放手术。MIRPS组的失血量显著降低(119 ml vs. 548 ml；pv。11.4%;P =0.0394)，手术时间较短(356 vs 396 min；P =0.0376)，术后发病率较低(0% vs. 28.6%；P =0.0006)，术后住院时间较短(9天vs. 15天；分别页= 0.3026)。MIRPS组的1、3、5年无复发生存率分别为88.5%、77.1%、71.6%，ORPS组的1、3、5年无复发生存率分别为85.7%、65.4%、65.4% （p=0.5631）。结论：MIRPS减少了围手术期并发症，缩短了术后住院时间，实现了与ORPS相当的无复发和总生存率。我们对HCC的标准化MIRPS程序被认为是安全、可行的，并且在肿瘤学上可接受用于选定的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Standardized Technique for Minimally Invasive Right Posterior Sectionectomy for Hepatocellular Carcinoma: A Propensity Score-matched Study.

Background/aim: Minimally invasive right posterior sectionectomy (MIRPS) for hepatocellular carcinoma (HCC) is a technically demanding anatomical liver resection procedure, characterized by restricted visibility and complex hemostatic control. Its effectiveness, compared to that of open surgery, is uncertain. Therefore, this study aimed to compare the perioperative and long-term oncological outcomes of MIRPS and open right posterior sectionectomy (ORPS) for HCC.

Patients and methods: Data of 122 consecutive patients, who underwent right posterior sectionectomy as initial treatment for primary HCC from January 2010 to February 2025, were retrospectively analyzed. Patients were allocated to MIRPS and ORPS groups, and surgical outcomes were compared using 1:1 propensity score matching (PSM).

Results: After PSM, the MIRPS and ORPS groups comprised 35 patients each. No procedures in the MIRPS group required conversion to open surgery. The MIRPS group demonstrated significantly lower blood loss (119 vs. 548 ml; p<0.0001), reduced transfusion rates (0% vs. 11.4%; p=0.0394), shorter operative durations (356 vs. 396 min; p=0.0376), lower postoperative morbidity rates (0% vs. 28.6%; p=0.0006), and shorter postoperative hospital stays (9 vs. 15 days; p<0.0001) compared to the ORPS group. The 1-, 3-, and 5-year overall survival rates were 100%, 96.3%, and 96.3% in the MIRPS group and 100%, 91.2%, and 87.9%, in the ORPS group (p=0.3026), respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 88.5%, 77.1%, and 71.6% in the MIRPS group and 85.7%, 65.4%, and 65.4%, in the ORPS group (p=0.5631), respectively.

Conclusion: MIRPS reduced perioperative complications, shortened postoperative hospital stay, and achieved recurrence-free and overall survival rates comparable to those of ORPS. Our standardized MIRPS procedure for HCC is considered safe, feasible, and oncologically acceptable for use in selected patients.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.