Antonella Delvecchio1, Maria Conticchio1, Umberto Riccelli2, Valentina Ferraro3, Francesca Ratti4, Maximiliano Gelli5, Ferdinando M Anelli6, Alexis Laurent7, Giulio C Vitali8, Paolo Magistri9, Giacomo Assirati9, Emanuele Felli10, Taiga Wakabayashi10, Patrick Pessaux10, Tullio Piardi11, Fabrizio Di Benedetto9, Nicola de'Angelis7, Javier Briceño-Delgado6, Rene Adam12, Daniel Cherqui12, Luca Aldrighetti4, Riccardo Memeo13. 1. General Surgery, University Hospital Policlinico of Bari, Italy. 2. Maxillo-Facial Surgery, Casa Sollievo Della Sofferenza Hospital, San Giovanni Rotondo, Italy. 3. Department of Hepato-Pancreatic-Biliary Surgery, Miulli Hospital, Bari, Italy. 4. Division of Hepatobiliary Surgery, IRCCS San Raffaele Hospital, Milan, Italy. 5. Department of Surgical Oncology, Institute of Oncology Gustave Roussy, Villejuif, France; Hepatobiliary Centre, Paul Brousse University Hospital, Villejuif, France. 6. Department of General Surgery and Liver and Pancreas Transplantation, University Hospital Reina Sofía, Córdoba, Spain. 7. Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor University Hospital, AP-HP, UPEC University, Créteil, France. 8. Division of Transplantation, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland. 9. Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy. 10. Department of Digestive Surgery, Strasbourg University Hospital, IRCAD, Strasbourg, France. 11. Department of HBP and Digestive Oncological Surgery, Robert Debré University Hospital, Reims, France; Department of Surgery, HPB Unit, Troyes Hospital, Troyes, France. 12. Hepatobiliary Centre, Paul Brousse University Hospital, Villejuif, France. 13. Department of Hepato-Pancreatic-Biliary Surgery, Miulli Hospital, Bari, Italy. Electronic address: info@drmemeoriccardo.com.
Abstract
BACKGROUND: Surgical resection is a first-line curative option for hepatocellular carcinoma, but its role is still unclear in elderly patients. The aim of our study was to compare short- and long-term outcomes of laparoscopic and open liver resection in elderly patients with hepatocellular carcinoma. METHODS: The study included 665 consecutive hepatocellular carcinoma liver resection cases in patients with ≥70 years of age treated in eight European hospital centres. Patients were divided into laparoscopic and open liver resection groups. Perioperative and long-term outcomes were compared between these groups. RESULTS: After a 1:1 propensity score matching, 219 patients were included in each group. Clavien-Dindo grades III/IV (6 vs. 20%, p = 0.04) were lower in the laparoscopic than in the open matched group. Hospital stay was shorter in the laparoscopic than in the open matched group (5 vs. 7 days, p < 0.001). There were no significant differences between laparoscopic and open groups regarding overall survival and disease-free survival at 1-, 3- and 5- year periods. CONCLUSION: Laparoscopic liver resection for hepatocellular carcinoma is associated with good short-term outcomes in patients with ≥70 years of age compared to open liver resection. Laparoscopic liver resection is safe and feasible in elderly patients with hepatocellular carcinoma.
BACKGROUND: Surgical resection is a first-line curative option for hepatocellular carcinoma, but its role is still unclear in elderly patients. The aim of our study was to compare short- and long-term outcomes of laparoscopic and open liver resection in elderly patients with hepatocellular carcinoma. METHODS: The study included 665 consecutive hepatocellular carcinoma liver resection cases in patients with ≥70 years of age treated in eight European hospital centres. Patients were divided into laparoscopic and open liver resection groups. Perioperative and long-term outcomes were compared between these groups. RESULTS: After a 1:1 propensity score matching, 219 patients were included in each group. Clavien-Dindo grades III/IV (6 vs. 20%, p = 0.04) were lower in the laparoscopic than in the open matched group. Hospital stay was shorter in the laparoscopic than in the open matched group (5 vs. 7 days, p < 0.001). There were no significant differences between laparoscopic and open groups regarding overall survival and disease-free survival at 1-, 3- and 5- year periods. CONCLUSION: Laparoscopic liver resection for hepatocellular carcinoma is associated with good short-term outcomes in patients with ≥70 years of age compared to open liver resection. Laparoscopic liver resection is safe and feasible in elderly patients with hepatocellular carcinoma.