Laparoscopic liver resection could be a safe, feasible, and effective therapeutic approach in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CCA), allowing for a shorter hospital stay without compromising oncological outcomes, according to a new study published in Annals of Gastroenterological Surgery.

“In our study, laparoscopic liver resection for cHCC-CCA had comparable [3-year] overall survival and disease-free survival compared to open hepatectomy,” the authors said.

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After propensity score matching, the 3-year overall survival rates were 83.3% for the laparoscopic liver resection group and 93.3% for the open liver resection group (P =.257). The 3-year disease-free survival rates were 56.7% for the laparoscopic liver resection group and 53.3% for the open liver resection group (P =.958).

The only category that was significantly different between the open liver resection and laparoscopic liver resection groups after propensity score matching was hospital stay (15.0 ±10.9 days vs 8.5 ± 2.4 days, respectively; P =.004).

The study enrolled 145 patients with a postoperative pathologic diagnosis of cHCC-CCA. Of those, 92 underwent open liver resection, while 43 underwent laparoscopic liver resection. Ten had palliative surgery and, therefore, were excluded from the study. The authors compared the groups before and after propensity score matching, which was done one-to-one using the nearest-neighbor matching method.

Propensity score matching yielded 30 patients (mean age, 57.43 ± 10.03 years in the laparoscopic liver resection group and 56.27 ± 9.86 years in the open liver resection group) from each group for subsequent analyses. The groups had the same ratio (83.3%) of patients without prior treatment, as well as a similar ratio of patients with liver cirrhosis at the time of operation (36.7% in the laparoscopic liver resection group vs 33.3% in the open liver resection group). No significant differences were detected in tumor number or pathologic T and N stages.

Reference

Lee SJ, Kang SH, Choi Y, et al. Long‐term outcomes of laparoscopic versus open liver resection for intrahepatic combined hepatocellular: cholangiocarcinoma with propensity score matching. Ann Gastroenterol Surg. Published online February 9, 2022. doi:10.1002/ags3.12555