So Hyun Kang1, YoungRok Choi2, Woohyung Lee3, Soyeon Ahn4, Jai Young Cho5, Yoo-Seok Yoon5, Ho-Seong Han5. 1. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea. 2. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: choiyoungrok@gmail.com. 3. Department of Surgery, Asan Medical Center, Seoul, South Korea. 4. Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 5. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea.
Abstract
INTRODUCTION: Laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma is debatable due to technical challenges associated with major hepatectomy and lymph node dissection. This study aims to analyze the long-term outcomes with propensity score matching. METHODS: Patients who underwent liver resection for intrahepatic cholangiocarcinoma from August 2004 to October 2015 were enrolled. Those who had combined hepatocellular-cholangiocarcinoma and palliative surgery were excluded. Medical records were reviewed for postoperative outcome, recurrence, and survival. The 3-year disease-free survival(DFS) and 3-year overall survival(OS) were set as the primary endpoint, and 3-year disease-specific survival, 1-year OS, 1-year DFS, operative outcome, and postoperative complications were secondary endpoints. RESULTS: A total of 91 patients were enrolled with 61 in the open group and 30 in the laparoscopic group. Propensity score matching included 24 patients in both groups. In total, the 3-year OS was 81.2% in the open group and 76.7% in the laparoscopic group(p = 0.621). For 3-year DFS, open was 42.5% and laparoscopic was 65.6%(p = 0.122). Mean operation time for the open group was 343.2 ± 106.0 min and laparoscopic group was 375.2 ± 204.0 min(p = 0.426). Hospital stay was significantly shorter in the laparoscopic group(9.8 ± 5.1 days) than the open group(18.3 ± 14.7, p=<0.001). There was no difference in complication rate and 30-day readmission rate. Tumor size, nodularity, and presence of perineural invasion showed an independent association with the 3-year DFS in multivariate analysis. CONCLUSION: Laparoscopic liver resection for intrahepatic cholangiocarcinoma is technically feasible and safe, providing short-term benefits without increasing complications or affecting long-term survival.
INTRODUCTION: Laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma is debatable due to technical challenges associated with major hepatectomy and lymph node dissection. This study aims to analyze the long-term outcomes with propensity score matching. METHODS:Patients who underwent liver resection for intrahepatic cholangiocarcinoma from August 2004 to October 2015 were enrolled. Those who had combined hepatocellular-cholangiocarcinoma and palliative surgery were excluded. Medical records were reviewed for postoperative outcome, recurrence, and survival. The 3-year disease-free survival(DFS) and 3-year overall survival(OS) were set as the primary endpoint, and 3-year disease-specific survival, 1-year OS, 1-year DFS, operative outcome, and postoperative complications were secondary endpoints. RESULTS: A total of 91 patients were enrolled with 61 in the open group and 30 in the laparoscopic group. Propensity score matching included 24 patients in both groups. In total, the 3-year OS was 81.2% in the open group and 76.7% in the laparoscopic group(p = 0.621). For 3-year DFS, open was 42.5% and laparoscopic was 65.6%(p = 0.122). Mean operation time for the open group was 343.2 ± 106.0 min and laparoscopic group was 375.2 ± 204.0 min(p = 0.426). Hospital stay was significantly shorter in the laparoscopic group(9.8 ± 5.1 days) than the open group(18.3 ± 14.7, p=<0.001). There was no difference in complication rate and 30-day readmission rate. Tumor size, nodularity, and presence of perineural invasion showed an independent association with the 3-year DFS in multivariate analysis. CONCLUSION: Laparoscopic liver resection for intrahepatic cholangiocarcinoma is technically feasible and safe, providing short-term benefits without increasing complications or affecting long-term survival.
Authors: Omid Salehi; Vera Kazakova; Eduardo A Vega; Onur C Kutlu; Sylvia V Alarcon; Richard Freeman; Olga Kozyreva; Claudius Conrad Journal: Surg Endosc Date: 2021-11-08 Impact factor: 3.453
Authors: Yang Jinhuan; Wang Yi; Zheng Yuanwen; Ma Delin; Chen Xiaotian; Wang Yan; Deng Liming; Yu Haitao; Wu Lijun; Deng Tuo; Chen Kaiyu; Hu Jiawei; Zheng Chongming; Wang Daojie; Jin Bin; Chen Gang Journal: Front Oncol Date: 2022-01-07 Impact factor: 6.244