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Wong et al. Hepatoma Res 2021;7:45 Hepatoma Research
DOI: 10.20517/2394-5079.2021.28

Original Article Open Access

Defining the role of laparoscopic liver resection in

elderly HCC patients: a propensity score matched
analysis

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Phoenix Wai Yan Wong , Ka Wing Ma , Tan To Cheung, Wong Hoi She, Wing Chiu Dai, Albert Chi Yan
Chan, Kenneth Siu Ho Chok, Chung Mau Lo
Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Authors contributed equally.
Correspondence to: Dr. Tan To Cheung, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong,
Room 340, Block L, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. E-mail: cheung68@hku.hk

How to cite this article: Wong PWY, Ma KW, Cheung TT, She WH, Dai WC, Chan ACY, Chok KSH, Lo CM. Defining the role of
laparoscopic liver resection in elderly HCC patients: a propensity score matched analysis. Hepatoma Res 2021;7:45.
https://dx.doi.org/10.20517/2394-5079.2021.28
Received: 1 Mar 2021 First Decision: 22 Apr 2021 Revised: 5 May2021 Accepted: 21 May 2021 First online: 24 May 2021

Academic Editor: Ho-Seong Han Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Aim: To elucidate the role and efficacy of laparoscopic liver resection for elderly patients with hepatocellular
carcinoma (HCC).

Methods: A retrospective comparative analysis was performed between laparoscopic and open liver resection
operated from year 2008 to 2018. Consecutive HCC patients aged 65 or above at the time of operation were
recruited. Patients with recurrent HCC and/or alternative pathology were excluded. Short-term and long-term
outcomes between the laparoscopic and the open group were compared. Propensity score matching of patients in
a ratio of 1:2 was conducted before comparison.
Results: A total of 911 patients underwent hepatectomy for primary HCC from 2008 to 2018. Among them, 320
elderly patients aged over 65 years old were eligible for analysis. Heterogeneities between laparoscopic and open
groups were identified namely pre-operative albumin level, aspartate transaminase, and magnitude of hepatectomy
(major vs. minor). After propensity score matching of 1:2, 46 patients in the laparoscopic group and 92 patients in
the open group were included for comparison. The laparoscopic group had less blood loss (326 mL vs. 735 mL; P <
0.001), shorter operative time (223 min vs. 324 min; P < 0.001), and shorter hospital stay (6.3 days vs. 10.5 days; P
< 0.001). No significant differences in postoperative morbidity and hospital mortality were noted between the
groups. For oncological outcome, the laparoscopic group had a superior disease-free survival (59.7% vs. 44.5%; P

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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