HCC: analysis points to laparoscopic resection for small, single tumors

  • Eur J Surg Oncol

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Laparoscopic liver resection (LLR) was associated with a higher recurrence-free survival and similar postoperation complication rate to radiofrequency ablation (RFA) in patients with single, small hepatocellular carcinoma (HCC).

Why this matters

  • LLR has the efficacy of open liver resection and the safety of RFA, suggesting it should be the first-line therapy in this patient population.

Study design

  • Propensity score-matched analyses of open LR vs RFA (n=182) and laparoscopic LR vs RFA (n=100).
  • Funding: None disclosed.

Key results

  • Open LR vs RFA:
    • No significant between-group difference in 3-year or 5-year OS.
    • 3-year recurrence-free survival (RFS): LR, 41% vs RFA, 30% (P
    • 5-year RFS: LR, 36% vs RFA, 21% (P<.001>
    • Median follow-up, 33 months. Death rate was higher in LR (36.2% vs 21.9%), but recurrence was lower (58% vs 69%).
  • LLR vs RFA:
    • After propensity-score matched analysis, cirrhosis was more common in RFA patients (89% vs 84%; P=.04), but less likely to be superficial (56% vs 86%; P<.01>
    • 3-year and 5-year OS rates were similar.
    • RFS was higher with LLR at 3 years (54% vs 26%; P<.001 and years vs p>
    • Perioperative comorbidity, 8% LLR vs 4% RFA (P=.43).

Limitations

  • Retrospective analysis.

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