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01-07-2021 | Laparoscopy

Laparoscopic major hepatectomy for hepatocellular carcinoma in elderly patients: a multicentric propensity score‑based analysis

Authors: Antonella Delvecchio, Maria Conticchio, Francesca Ratti, Maximiliano Gelli, Ferdinando Massimiliano Anelli, Alexis Laurent, Giulio Cesare Vitali, Paolo Magistri, Giacomo Assirati, Emanuele Felli, Taiga Wakabayashi, Patrick Pessaux, Tullio Piardi, Fabrizio Di Benedetto, Nicola de’Angelis, Javier Briceño-Delgado, Rene Adam, Daniel Cherqui, Luca Aldrighetti, Riccardo Memeo

Published in: Surgical Endoscopy | Issue 7/2021

Abstract

Background

Considering the increase in overall life expectancy and the rising incidence of hepatocellular carcinoma (HCC), more elderly patients are considered for hepatic resection. Traditionally, major hepatectomy has not been proposed to the elderly due to severe comorbidities. Indeed, only a few case series are reported in the literature. The present study aimed to compare short-term and long-term outcomes between laparoscopic major hepatectomy (LMH) and open major hepatectomy (OMH) in elderly patients with HCC using propensity score matching (PSM).

Methods

We performed a multicentric retrospective study including 184 consecutive cases of HCC major liver resection in patients aged ≥ 70 years in _8 European Hospital Centers. Patients were divided into LMH and OMH groups, and perioperative and long-term outcomes were compared between the 2 groups.

Results

After propensity score matching, 122 patients were enrolled, 38 in the LMH group and 84 in the OMH group. Postoperative overall complications were lower in the LMH than in the OMH group (18 vs. 46%, p < 0.001). Hospital stay was shorter in the LMH group than in the OMH group (5 vs. 7 days, p = 0.01). Mortality at 90 days was comparable between the two groups. There were no significant differences between the two groups in terms of overall survival (OS) and disease-free survival (DFS) at 1, 3, and 5 years.

Conclusion

LMH for HCC is associated with appropriate short-term outcomes in patients aged ≥ 70 years as compared to OMH. LMH is safe and feasible in elderly patients with HCC.

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Title: Laparoscopic major hepatectomy for hepatocellular carcinoma in elderly patients: a multicentric propensity score‑based analysis
Authors: Antonella Delvecchio
Maria Conticchio
Francesca Ratti
Maximiliano Gelli
Ferdinando Massimiliano Anelli
Alexis Laurent
Giulio Cesare Vitali
Paolo Magistri
Giacomo Assirati
Emanuele Felli
Taiga Wakabayashi
Patrick Pessaux
Tullio Piardi
Fabrizio Di Benedetto
Nicola de’Angelis
Javier Briceño-Delgado
Rene Adam
Daniel Cherqui
Luca Aldrighetti
Riccardo Memeo
Publication date: 01-07-2021
Publisher: Springer US
Keywords: Laparoscopy
Liver Resection
Liver Resection
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Surgical Endoscopy / Issue 7/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07843-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic major hepatectomy for hepatocellular carcinoma in elderly patients: a multicentric propensity score‑based analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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