Laparoscopy seems to lead to better short-term outcomes in patients with intrahepatic cholangiocarcinoma (iCCA) compared to open surgery, according to a new study published in Frontiers in Oncology. These include less blood loss and shorter operation time and hospital stay.

Laparoscopy may also have certain advantages in the long-term for early iCCA, the authors said. To compare the short-term and long-term effects of laparoscopy and open surgery in iCCA treatment, a team of researchers from China analyzed data from 1084 patients treated at 3 different hospitals between January 2011 and December 2018.

Of these, 244 patients in the all-stage group and 65 patients in the early-stage group were included in the analysis. Long-term outcomes that were considered were overall survival and recurrence-free survival while short-term outcomes that were considered were perioperative.


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The results showed that short-term outcomes were better in patients treated with laparoscopy compared to those treated with open surgery. More precisely, while 22.1% of patients treated with open surgery lost 400 mL of blood or more, only 4.92% of those treated with laparoscopy lost that much blood.

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When early-stage patients were considered only, blood loss of 400 mL occurred in 31.6% of those treated with open surgery and 7.41% of those treated with laparoscopy. The surgery time was also significantly shorter in early-stage patients with 125 minutes on average with laparoscopy vs 200 minutes on average for open surgery.

Finally, the average hospital stay was 11 days for patients treated with open surgery vs 9 days for those treated with laparoscopy. There were no significant differences in terms of long-term outcomes for all stage patients but for early-stage patients who were treated with open surgery, the 1-year overall survival rate was 84.2%, the 3-year overall survival rate was 65.8%, and the 5-year overall survival rate was 41.1%.

But for patients treated with laparoscopy, these rates were 100%, 90.9%, and 90.9% for 1, 3, and 5 years. Similarly, the recurrence-free survival of patients treated with laparoscopy was better than that of those treated with open surgery with 92.3%, 92.3%, and 92.3% for 1, 3, and 5 years vs 84.2%, 66.7%, and 41.7% for 1, 3, and 5 years.

Future research should explore other outcomes for early-stage patients such as the development of long-term complications and focus on improving the quality of life in these patients, the researchers said. Surgical resection is currently the only widely accepted curative approach for iCCA.

Reference

Jinhuan Y, Yi W, Yuanwen Z, et al. Laparoscopic versus open surgery for early-stage intrahepatic cholangiocarcinoma after mastering the learning curve: a multicenter data-based matched study. Front Oncol. 2022;7(11):742544. doi:10.3389/fonc.2021.742544