Hybrid-including endoscopic versus open hepatic resection for patients with hepatocellular carcinoma meeting the Milan criteria: a propensity case-matched analysis.
OBJECTIVE
To clarify the surgical outcome of patients who underwent endoscopic hepatectomy (EH) compared to those of conventional open hepatectomy (OH) for hepatocellular carcinoma (HCC).


METHODS
Between 1999 and 2011, 269 HCC patients meeting the Milan criteria were divided into EH (n=89) and OH groups (n=180). To equalize the background covariates, a one-to-one propensity case-matched analysis was used.


RESULTS
With propensity matching, 52 EH and 52 OH patients showed comparable preoperative clinical characteristics. The operation time (320 min, p=0.049) and the median blood loss (180 g, p<0.001) was significantly lesser with EH, while the median postoperative hospital stay (11 days, p=0.002) was significantly shorter for EH. The cumulative disease-free and overall survival rates were equivalent in both groups.


CONCLUSIONS
EH for HCC patients meeting the Milan criteria is less invasive and might provide an equivalent disease-free and overall survival when compared to conventional OH.
Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University, Kumamoto, Japan Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan tbeppu@kumamoto-u.ac.jp.
Toru
T
Beppu
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hiromitsu
H
Hayashi
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hirohisa
H
Okabe
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Katsunori
K
Imai
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hidetoshi
H
Nitta
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Toshiro
T
Masuda
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Daisuke
D
Hashimoto
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Akira
A
Chikamoto
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Takatoshi
T
Ishiko
Medical Quality Management Center, Kumamoto University, Kumamoto, Japan.
Ken
K
Kikuchi
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hideo
H
Baba
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D057216:Propensity Score
Endoscopic hepatectomy; Milan criteria; hepatocellular carcinoma; open hepatectomy; propensity case-matched analysis