Comparison Of Short-term And Long-term Outcomes Between Laparoscopic And Conventional Open Liver Resection For Hepatocellular Carcinoma Larger Than 5cm:A Propensity Score Study

BACKGROUND ＆ AIMS: Although laparoscopic liver resection（LLR）is matured surgical procedure for hepatocellular carcinoma（HCC）,its prognosis for lager HCC（>5cm）remains controversial.The aim of this study is to compare the short-term and long-term oncologic outcomes between open and laparoscopic hepatectomy for large HCC.METHODS: Patients undergoing curative-intent liver resection for HCC were identified from a Chinese database.Propensity score matching（PSM）and inverse probability treatment weighting（IPTW）Kaplan-Meier curve were created.Univariable and multivariable Cox-regression analyses were performed to identify the risk factors associated with overall survival（OS）and recurrence free survival（RFS）.RESULTS: Among 265 patients with large HCC who underwent liver resection,LLR group（n= 119）were more likely to have better tumor pathological characteristics,performance status and shorter postoperative hospital stay than OLR group（n= 146）.Using PSM and IPTW analysis,Postoperative morbidity and mortality were comparable between the OLR and LLR groups.There are no difference for OS and RFS between two groups before and after adjustment.After adjustment for other confounding factors on multivariable analyses,LLR was not independently associated with poorer OS and RFS.CONCLUSIONS: LLR for large HCC patients showed better perioperative outcomes and equivalent long-term tumorous outcomes as OLR,providing evidence for considering as a standard laparoscopic practice through sufficient surgeon experience and careful patient selection.