BACKGROUND Repeated liver resection is an effective treatment for recurrent hepatocellular carcinoma(HCC).However,few studies have compared the outcome of laparoscopic repeat hepatectomy(LRH)and open repeat hepatectom...BACKGROUND Repeated liver resection is an effective treatment for recurrent hepatocellular carcinoma(HCC).However,few studies have compared the outcome of laparoscopic repeat hepatectomy(LRH)and open repeat hepatectomy(ORH)for recurrent HCC,and few of those have included cirrhotic patients.AIM To compare short-term and long-term outcomes of cirrhotic patients with LRH and ORH for recurrent HCC.METHODS We retrospectively analysed the clinical records retrieved from a prospectively collected database of all patients who underwent hepatectomy for posthepatectomy recurrent HCC at our institute between May 2006 and June 2021.Cases of recurrent HCCs larger than 7 cm were excluded.Patient demographics,operative details,perioperative outcomes,pathologic details,disease-free survival(DFS),and overall survival(OS)data of LRH and ORH were compared.RESULTS Data from 29 patients with LRH and 22 with ORH were compared.The LRH group showed significantly better outcomes for blood loss(median 300 mL vs 750 mL,P=0.013)and length of hospital stay(median 5 d vs 7 d,P=0.003).The 1-,3-and 5-year OS rates in the LRH group were 100.0%,60.0%and 30.0%,respectively;the corresponding rates in the ORH group were 81.8%,36.4%and 18.2%(P=0.336).The 1-,3-and 5-year DFS rates in the LRH group were 68.2%,27.3%and 4.5%,respectively;the corresponding rates in the ORH group were 31.3%,6.3%and 6.3%(P=0.055).There were no significant differences in overall and DFS between the two groups.CONCLUSION Laparoscopic re-resection should be considered for patients presenting with recurrent HCC less than or equal to 7 cm after previous hepatectomy.展开更多
文摘BACKGROUND Repeated liver resection is an effective treatment for recurrent hepatocellular carcinoma(HCC).However,few studies have compared the outcome of laparoscopic repeat hepatectomy(LRH)and open repeat hepatectomy(ORH)for recurrent HCC,and few of those have included cirrhotic patients.AIM To compare short-term and long-term outcomes of cirrhotic patients with LRH and ORH for recurrent HCC.METHODS We retrospectively analysed the clinical records retrieved from a prospectively collected database of all patients who underwent hepatectomy for posthepatectomy recurrent HCC at our institute between May 2006 and June 2021.Cases of recurrent HCCs larger than 7 cm were excluded.Patient demographics,operative details,perioperative outcomes,pathologic details,disease-free survival(DFS),and overall survival(OS)data of LRH and ORH were compared.RESULTS Data from 29 patients with LRH and 22 with ORH were compared.The LRH group showed significantly better outcomes for blood loss(median 300 mL vs 750 mL,P=0.013)and length of hospital stay(median 5 d vs 7 d,P=0.003).The 1-,3-and 5-year OS rates in the LRH group were 100.0%,60.0%and 30.0%,respectively;the corresponding rates in the ORH group were 81.8%,36.4%and 18.2%(P=0.336).The 1-,3-and 5-year DFS rates in the LRH group were 68.2%,27.3%and 4.5%,respectively;the corresponding rates in the ORH group were 31.3%,6.3%and 6.3%(P=0.055).There were no significant differences in overall and DFS between the two groups.CONCLUSION Laparoscopic re-resection should be considered for patients presenting with recurrent HCC less than or equal to 7 cm after previous hepatectomy.
