Short-Term Outcomes of Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma in Elderly Patients: A Propensity Score Matching Analysis

Abstract

\n BackgroundThe number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.MethodsBetween 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (aged\u2009>\u200970 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.ResultsAfter PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL, LLR: 50 mL [P\u2009<\u20090.001]), length of postoperative hospital stay (OLR: 12 days, LLR: 7 days [P\u2009<\u20090.001]), and time to start oral intake (OLR: 2 days, LLR: 1 day [P\u2009<\u20090.001]) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.ConclusionsOur results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.Trial registration: retrospectively registered