Long-Term Oncological Outcomes of Laparoscopic Liver Resection for Solitary Hepatocellular Carcinoma: Comparison of Anatomical and Nonanatomical Resection Using Propensity Score Matching Analysis

Abstract

<b><i>Aim:</i></b> There is no evidence indicating that survival improvement is associated with anatomical laparoscopic liver resection (ALLR) rather than non-ALLR (NALLR) to treat solitary hepatocellular carcinoma (HCC). The aim of our study was to compare the oncological outcomes of ALLR versus NALLR. <b><i>Materials and Methods:</i></b> From January 2008 to September 2014, 231 patients underwent LLR as the primary treatment for solitary HCC without portal vein tumor thrombus. After matching one-to-one propensity scores, 118 patients were included in 2 groups: NALLR (<i>n</i> = 59) and ALLR (<i>n</i> = 59). <b><i>Results:</i></b> In the propensity-matched cohort, the 1-, 3-, and 5-year recurrence-free survival rates were 84.4%, 73.8%, and 68.4% in the ALLR group and 87.7%, 78.7%, and 73.5% in the NALLR group (<i>P</i> = .602). In multivariate analysis, the independent risk factors affecting HCC recurrence were higher preoperative PIVKA-II (prothrombin induced by vitamin K absence or antagonist-II) levels (<i>P</i> = .041) and microvascular invasion (<i>P</i> = .030). The risk factor affecting liver-related mortality was determined to be higher preoperative PIVKA-II levels (<i>P</i> = .007). <b><i>Conclusions:</i></b> In the propensity-matched cohort, long-term outcomes of the NALLR group were not inferior to those of the ALLR group.