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  • Comparison between short an...
    Goh, Brian K. P.; Syn, Nicholas; Koh, Ye‐Xin; Teo, Jin‐Yao; Cheow, Peng‐Chung; Jeyaraj, Prema R.; Chow, Pierce K. H.; Ooi, London L. P. J.; Chung, Alexander Y. F.; Chan, Chung‐Yip

    Journal of surgical oncology, 09/2021, Letnik: 124, Številka: 4
    Journal Article

    Background This study aims to compare the short‐ and long‐term outcomes of patients undergoing minimally invasive liver resection (MILR) versus open liver resection (OLR) for nonrecurrent hepatocellular carcinoma (HCC). Methods Review of 204 MILR and 755 OLR without previous LR performed between 2005 and 2018. 1:1 coarsened exact matching (CEM) and 1:1 propensity‐score matching (PSM) were performed. Results Overall, 190 MILR were well‐matched with 190 OLR by PSM and 86 MILR with 86 OLR by CEM according to patient baseline characteristics. After PSM and CEM, MILR was associated with a significantly longer operation time 230 min (interquartile range IQR, 145–330) vs. 160 min (IQR, 125–210), p < .001 215 min (IQR, 135–295) vs. 153.5 min (120–180), p < .001, shorter postoperative stay 4 days (IQR, 3–6) vs. 6 days (IQR, 5–8), p = .001) 4 days (IQR, 3–5) vs. 6 days (IQR, 5–7), p = .004 and lower postoperative morbidity 40 (21%) vs. 67 (35.5%), p = .003 16 (18.6%) vs. 27 (31.4%), p = .036 compared to OLR. MILR was also associated with a significantly longer median time to recurrence (70 vs. 40.3 months, p = .014) compared to OLR after PSM but not CEM. There was no significant difference in terms of overall survival and recurrence‐free survival. Conclusion MILR is associated with superior short‐term postoperative outcomes and with at least equivalent long‐term oncological outcomes compared to OLR for HCC.