Comparison of laparoscopic versus open liver resection for hepatocellular carcinoma using propensity score matching
Laparoscopic liver resection (LLR) has become one of standard treatments for hepatocellular carcinoma (HCC). Numerous reports have demonstrated that LLR might be less invasive and provide better short-term results and identical oncological outcome compared to conventional open liver resection (OLR); however almost reports in the past were not conclusive. Propensity score matching (PSM) is a quite useful tool to match different background factors in the two groups; therefore, we reviewed papers assessing laparoscopic and OLR using PSM. We have already published the largest study of LLR for HCC from the “Project Committee of the Endoscopic Surgery” of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. We summarized 10 documents including this paper. After PSM, maximum 387 patients undergoing laparoscopic and OLR were investigated. Less intraoperative blood loss or low rate of blood transfusion, and shorter hospital stay are solid advantageous results of LLR. Long-term outcome was quite equivalent in the two groups and special recurrence pattern in the LLR was rarely observed. These PSM studies clearly demonstrated that LLR can provide excellent perioperative benefits without oncologic disadvantages; therefore, we can strongly recommend LLR as a standard practice for properly selected patients with HCC.