title: Long-term outcome of laparoscopic versus open liver resection for hepatocellular carcinoma: a case-controlled study with propensity score matching.
abstract: BACKGROUND
  Laparoscopic liver resection (LR) for hepatocellular carcinoma (HCC) is usually applied to superficial and left-side small lesions. Therefore, well designed comparative studies about the results of LR versus open liver resection (OR) for HCC are difficult and still uncommon. The aim of this study was to compare the perioperative and long-term oncologic outcomes of LR versus OR for HCC between well-matched patient groups.
  
  
  METHODS
  Between January 2000 and March 2012, 205 patients (43 with intent-to-treat with LR, 162 OR) underwent primary liver resection of less than three segments for HCC in our center. To select a comparison group, propensity score matching (PSM) was used at 1:1 ratio with covariates of baseline characteristics, including tumor characteristics. Outcomes were compared between the matched groups.
  
  
  RESULTS
  The two groups were well balanced by PSM and 29 patients were matched respectively. In LR, there was more non-anatomical resection (65.5 vs. 34.5 %; p = 0.012), less postoperative ascites (0.0 vs. 17.2 %; p = 0.025), and shorter hospital stay (7.69 ± 2.94 vs. 13.38 ± 7.37 days; p < 0.001). With the exception of these, there were no significant differences in perioperative and long-term outcomes. The 1-, 3- and 5-year survivals were 100, 100 and 92.2 % in LR, and 96.5, 92.2 and 87.7 % in OR (p = 0.267), respectively. The 1-, 3- and 5-year disease-free survivals were 81.7, 61.7 and 54.0 % in LR, and 78.6, 60.9 and 40.1 % in OR, respectively (p = 0.929).
  
  
  CONCLUSIONS
  The outcome of LR for HCC was technically feasible and safe in selected patients, and LR showed similar perioperative and long-term oncologic outcomes when compared with OR matched with PSM.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
authors.forename: Hyeyoung
authors.initials: H
authors.lastname: Kim
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.forename: Kwang-Woong
authors.initials: KW
authors.lastname: Lee
authors.forename: Nam-Joon
authors.initials: NJ
authors.lastname: Yi
authors.forename: Geun
authors.initials: G
authors.lastname: Hong
authors.forename: Suk-Won
authors.initials: SW
authors.lastname: Suh
authors.forename: Tae
authors.initials: T
authors.lastname: Yoo
authors.forename: Min-Su
authors.initials: MS
authors.lastname: Park
authors.forename: Youngrok
authors.initials: Y
authors.lastname: Choi
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Lee
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome