Recurrence of Hepatocellular Carcinoma After Laparoscopic Hepatectomy: Risk Factors and Treatment Strategies.
OBJECTIVE
To investigate the risk factors for recurrence and treatment strategies after patients with hepatocellular carcinoma (HCC) undergo total laparoscopic hepatectomy (LH).


METHODS
The study included 109 patients who underwent LH (laparoscopy resection [LR] group, n = 50) or open hepatectomy [OH] (open resection [OR] group, n = 59) for HCC in our hospital between March 2011 and June 2016. Perioperative outcomes, disease recurrence, survival, and risk factors for recurrence were analyzed.


RESULTS
Patient characteristics did not significantly differ between groups. The 1- and 3-year survival rates were 90.7% and 78.1%, respectively, for the LR group and 83.1% and 74.4%, respectively, for the OR group (P = .71). The 1- and 3-year disease-free survival rates were 89.6% and 51.4%, respectively, for the LR group and 84.7% and 59.6%, respectively, for the OR group (P = .935). Tumor size, differentiation, vascular invasion, surgical bleeding, and surgical resection margin were risk factors for tumor recurrence after LH.


CONCLUSIONS
LH for HCC did not increase the risk of recurrence compared with OH. Tumor size, differentiation, vascular invasion, surgical bleeding, and surgical resection margin were risk factors for tumor recurrence. Reducing bleeding during surgery and ensuring sufficient surgical margins were the most important measures to reduce postoperative recurrence of HCC.
1 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong University, Research Institute of Hepatobiliary Surgery of Nantong University , Nantong, P.R. China.
Xiaodong
X
Xu
2 Department of Cardiology, Zhongshan Hospital, Fudan University , Shanghai, P.R. China .
Jiahui
J
Chen
1 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong University, Research Institute of Hepatobiliary Surgery of Nantong University , Nantong, P.R. China.
Feiran
F
Wang
1 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong University, Research Institute of Hepatobiliary Surgery of Nantong University , Nantong, P.R. China.
Qinggan
Q
Ni
1 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong University, Research Institute of Hepatobiliary Surgery of Nantong University , Nantong, P.R. China.
Ullah
U
Naimat
1 Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong University, Research Institute of Hepatobiliary Surgery of Nantong University , Nantong, P.R. China.
Zhong
Z
Chen
D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000601:surgery; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery; D011183:Postoperative Complications; D012307:Risk Factors
hepatocellular carcinoma; laparoscopic hepatectomy; recurrence; strategy; survival