Multicenter propensity score-based study of laparoscopic repeat liver resection for hepatocellular carcinoma: A subgroup analysis of cases with tumors far from major vessels

Arimasa Miyama, Zenichi Morise, Luca Aldrighetti, Giulio Belli, Francesca Ratti, Tan To Cheung, Chung Mau Lo, Shogo Tanaka, Shoji Kubo, Yukiyasu Okamura, Katsuhiko Uesaka, Kazuteru Monden, Hiroshi Sadamori, Kazuki Hashida, Kazuyuki Kawamoto, Naoto Gotohda, Kuohsin Chen, Akishige Kanazawa, Yutaka Takeda, Yoshiaki OhmuraMasaki Ueno, Toshiro Ogura, Kyung Suk Suh, Yutaro Kato, Atsushi Sugioka, Andrea Belli, Hiroyuki Nitta, Masafumi Yasunaga, Daniel Cherqui, Nasser Abdul Halim, Alexis Laurent, Hironori Kaneko, Yuichiro Otsuka, Ki Hun Kim, Hwui Dong Cho, Charles Chung Wei Lin, Yusuke Ome, Yasuji Seyama, Roberto I. Troisi, Giammauro Berardi, Fernando Rotellar, Gregory C. Wilson, David A. Geller, Olivier Soubrane, Tomoaki Yoh, Takashi Kaizu, Yusuke Kumamoto, Ho Seong Han, Ela Ekmekcigil, Ibrahim Dagher, David Fuks, Brice Gayet, Joseph F. Buell, Ruben Ciria, Javier Briceno, Nicholas O’rourke, Joel Lewin, Bjorn Edwin, Masahiro Shinoda, Yuta Abe, Mohammed Abu Hilal, Mohammad Alzoubi, Minoru Tanabe, Go Wakabayashi

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9 Citations (Scopus)


Less morbidity is considered among the advantages of laparoscopic liver resection (LLR) for HCC patients. However, our previous international, multi-institutional, propensity score-based study of emerging laparoscopic repeat liver resection (LRLR) failed to prove this advantage. We hypothesize that these results may be since the study included complex LRLR cases performed during the procedure’s developing stage. To examine it, subgroup analysis based on propensity score were performed, defining the proximity of the tumors to major vessels as the indicator of complex cases. Among 1582 LRLR cases from 42 international high-volume liver surgery centers, 620 cases without the proximity to major vessels (more than 1 cm far from both first–second branches of Glissonian pedicles and major hepatic veins) were selected for this subgroup analysis. A propensity score matching (PSM) analysis was performed based on their patient characteristics, preoperative liver function, tumor characteristics and surgical procedures. One hundred and fifteen of each patient groups of LRLR and open repeat liver resection (ORLR) were earned, and the outcomes were compared. Backgrounds were well-balanced between LRLR and ORLR groups after matching. With comparable operation time and long-term outcome, less blood loss (283.3±823.0 vs. 603.5±664.9 mL, p = 0.001) and less morbidity (8.7 vs. 18.3 %, p = 0.034) were shown in LRLR group than ORLR. Even in its worldwide developing stage, LRLR for HCC patients could be beneficial in blood loss and morbidity for the patients with less complexity in surgery.

Original languageEnglish
Article number3187
Issue number13
Publication statusPublished - 01-07-2021

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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