title: Laparoscopic resection of hepatocellular carcinoma: a French survey in 351 patients.
abstract: OBJECTIVE
  Current clinical studies report the results of laparoscopic resection of hepatocellular carcinoma (HCC) obtained in small cohorts of patients. Because France was involved in the very early development of laparoscopic surgery, the present study was conducted in order to report the results of a large, multicentre experience.
  
  
  METHODS
  A total of 351 patients underwent laparoscopic liver resection for HCC during the period from 1998 to 2010 in nine French tertiary centres. Patient characteristics, postoperative mortality and morbidity, and longterm survival were retrospectively reviewed.
  
  
  RESULTS
  Overall, 85% of the study patients had underlying liver disease. Types of resection included wedge resection (41%), left lateral sectionectomy (27%), segmentectomy (24%), and major hepatectomy (11%). Median operative time was 180 min. Conversion to laparotomy occurred in 13% of surgeries and intraoperative blood transfusion was necessary in 5% of patients. The overall morbidity rate was 22%. The 30-day postoperative mortality rate was 2%. Negative resection (R0) margins were achieved in 92% of patients. Rates of overall and progression-free survival at 1, 3 and 5 years were 90.3%, 70.1% and 65.9%, and 85.2%, 55.9% and 40.4%, respectively.
  
  
  CONCLUSIONS
  This multicentre, large-cohort study confirms that laparoscopic liver resection for HCC is a safe and efficient approach to treatment and can be proposed as a first-line treatment in patients with resectable HCC.
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplant, St Antoine Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University of Pierre and Marie Curie (UPMC), Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
authors.forename: Claire
authors.initials: C
authors.lastname: Goumard
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.forename: Hadrien
authors.initials: H
authors.lastname: Tranchart
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Truant
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
authors.forename: Chadi
authors.initials: C
authors.lastname: Salloum
authors.forename: Guillaume
authors.initials: G
authors.lastname: Luc
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.forename: Tullio
authors.initials: T
authors.lastname: Piardi
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dagher
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Eric
authors.initials: E
authors.lastname: Vibert
authors.forename: Antonio
authors.initials: A
authors.lastname: Sa Cunha
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boelle
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005602:France; D019538:Health Care Surveys; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome