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David et al. Hepatoma Research 2018;4:2 Hepatoma Research
DOI: 10.20517/2394-5079.2017.51

Original Article Open Access

Comparison of outcomes between laparoscopic
vs. open liver resection for intermediate stage
hepatocellular carcinoma

Avril David , YoungRok Choi , Ho-Seong Han , Yoo-Seok Yoon , Jai Young Cho 1
1
1,2
1
1
1 Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si,
Gyeonggi-do 13620, South Korea.
2 Department of Surgery, Rizal Medical Center, Pasig City 1600, Philippines.
Correspondence to: Dr. YoungRok Choi, Department of Surgery, Seoul National University Bundang Hospital82, Gumi-ro 173 Beon-gil,
Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea. E-mail: choiyoungrokr@gmail.com

How to cite this article: David A, Choi YR, Han HS, Yoon YS, Cho JY. Comparison of outcomes between laparoscopic vs. open liver
resection for intermediate stage hepatocellular carcinoma. Hepatoma Res 2018;4:2. http://dx.doi.org/10.20517/2394-5079.2017.51

Received: 8 Dec 2017 First Decision: 11 Dec 2017 Revised: 18 Dec 2017 Accepted: 19 Dec 2017 Published: 18 Jan 2018
Science Editor: Kenneth S.H. Chok Copy Editor: Lu Liu Production Editor: Huan-Liang Wu

Abstract
Aim: The Barcelona Clinic Liver Score (BCLC) currently limits hepatic resection only for small, solitary tumors
measuring 2-3 cm with no signs of portal hypertension (PHT) or macrovascular invasion. The aim of this study
was to show the benefit of surgical resection, and to compare the peri-operative and long-term outcomes between
laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma (HCC) classified as
intermediate stage (B) under BCLC.

Methods: From 2004 to 2013, 49 patients staged as intermediate (BCLC B) and who underwent hepatic
resection was included. These patients were divided into LLR or OLR. Demographics, tumor characteristics,
recurrence rates and overall survival (OS) were compared between the 2 groups.

Results: Forty-nine patients were included and grouped into LLR (n = 28) and OLR (n = 21). The average tumor
number was 2 ± 1 for both groups, while the mean tumor size was 4.4 ± 1.7 cm and 5.3 ± 2.6 cm for the LLR and
OLR group, respectively. When compared with OLR, LLR had lower post-operative complications (14.3% vs.
33.3%, P = 0.114), and a statistically significant shorter hospital stay than the OLR group (9 vs. 21 days, P = 0.023).
The LLR group also achieved a statistically significant difference in complete R0 resection as compared with the
OLR group (P = 0.016). The OS and disease-free survival (DFS) at 1, 3 and 5 years were comparable between LLR
and OLR (OS: 89.1% vs. 76.2%; 70.4% vs. 55.9%; 58.6% vs. 43.5%, P = 0.583; DFS: 59.3% vs. 51.0%; 20.2% vs.
44.6%; 16.2% vs. 37.2%, P = 0.947, respectively).

Conclusion: LLR showed comparable outcomes compared to OLR in the treatment of HCC staged BCLC B.
Therefore, LLR as well as OLR can be considered in selective patients in the BCLC B group.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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