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Background <p>Despite the expanding indications for laparoscopic liver resection (LLR), its role in hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains unclear. The aim of the current study is to compare the short- and long-term outcomes following LLR and open liver resection (OLR) for HCC with PVTT.</p> Methods <p>All HCC patients with PVTT registered for surgery between April 2015 and May 2022 were enrolled. Patients were divided into LLR and OLR groups, and postoperative recovery and oncological outcomes were analyzed.</p> Results <p>Twenty-eight patients in the LLR group and one hundred seventeen patients in the OLR group were included for comparison. The blood loss was less and the postoperative hospital stay was shorter in LLR group compared to OLR group both before and after propensity score matching. The median recurrence-free survival (RFS) time did not significantly differ between the two groups (8.0 months [95% CI 3.1–13.0] vs. 7.5 months [95% CI 6.0–9.1]; <i>P</i> = 0.845). In stratified analysis, both the recurrence pattern and the median RFS time were comparable between the LLR group and the OLR group in type I PVTT (7.23 [95% CI 0.35–14.12] vs. 7.17 months [95% CI 3.49–10.85]; <i>P</i> = 0.794) and type II PVTT (8.96 [95% CI 0–19.56] vs. 7.60 months [95% CI 5.98–9.22], <i>P</i> = 0.651), respectively. The multivariate regression analysis showed that the tumor size ≥ 10&#xa0;cm, AFP &gt; 200&#xa0;ng/ml, and HBV-DNA &gt; 1000 copies/ml were independent risk factors for RFS.</p> Conclusion <p>LLR for HCC patients with type I/II PVTT could be safely performed with superior short-term recovery and similar long-term survival compared to OLR. Larger tumor size, higher AFP, and elevated HBV-DNA levels contribute to worse RFS.</p>

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Short- and long-term outcomes following laparoscopic liver resection for hepatocellular carcinoma combined with type I/II portal vein tumor thrombus

  • 期刊论文

  • 发表日期：

    2025年1月13日

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  • Haili Zhang,
  • Hongwei Xu,
  • Ningyuan Wen,
  • Bo Li,
  • Kefei Chen,
  • Yonggang Wei

摘要

Background

Despite the expanding indications for laparoscopic liver resection (LLR), its role in hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains unclear. The aim of the current study is to compare the short- and long-term outcomes following LLR and open liver resection (OLR) for HCC with PVTT.

Methods

All HCC patients with PVTT registered for surgery between April 2015 and May 2022 were enrolled. Patients were divided into LLR and OLR groups, and postoperative recovery and oncological outcomes were analyzed.

Results

Twenty-eight patients in the LLR group and one hundred seventeen patients in the OLR group were included for comparison. The blood loss was less and the postoperative hospital stay was shorter in LLR group compared to OLR group both before and after propensity score matching. The median recurrence-free survival (RFS) time did not significantly differ between the two groups (8.0 months [95% CI 3.1–13.0] vs. 7.5 months [95% CI 6.0–9.1]; P = 0.845). In stratified analysis, both the recurrence pattern and the median RFS time were comparable between the LLR group and the OLR group in type I PVTT (7.23 [95% CI 0.35–14.12] vs. 7.17 months [95% CI 3.49–10.85]; P = 0.794) and type II PVTT (8.96 [95% CI 0–19.56] vs. 7.60 months [95% CI 5.98–9.22], P = 0.651), respectively. The multivariate regression analysis showed that the tumor size ≥ 10 cm, AFP > 200 ng/ml, and HBV-DNA > 1000 copies/ml were independent risk factors for RFS.

Conclusion

LLR for HCC patients with type I/II PVTT could be safely performed with superior short-term recovery and similar long-term survival compared to OLR. Larger tumor size, higher AFP, and elevated HBV-DNA levels contribute to worse RFS.