Author:
Li He,Meng Lingzhan,Yu Simiao,Zheng Haocheng,Yu Lingxiang,Wang Hongbo,Ren Hui,Li Hu,Zhang Xiaofeng,Wang Zizheng,Yu Peng,Hu Xiongwei,Yang Muyi,Yan Jin,Shao Yanling,Cao Li,Ding Xia,Hong Zhixian,Zhu Zhenyu
Abstract
Abstract
Background
Evidence concerning long-term outcome of robotic liver resection (RLR) and laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) patients is scarce.
Methods
This study enrolled all patients who underwent RLR and LLR for resectable HCC between July 2016 and July 2021. Propensity score matching (PSM) was employed to create a 1:3 match between the RLR and LLR groups. A comprehensive collection and analysis of patient data regarding efficacy and safety have been conducted, along with the evaluation of the learning curve for RLR.
Results
Following PSM, a total of 341 patients were included, with 97 in the RLR group and 244 in the LLR group. RLR group demonstrated a significantly longer operative time (median [IQR], 210 [152.0–298.0] min vs. 183.5 [132.3–263.5] min; p = 0.04), with no significant differences in other perioperative and short-term postoperative outcomes. Overall survival (OS) was similar between the two groups (p = 0.43), but RLR group exhibited improved recurrence-free survival (RFS) (median of 65 months vs. 56 months, p = 0.006). The estimated 5-year OS for RLR and LLR were 74.8% (95% CI: 65.4–85.6%) and 80.7% (95% CI: 74.0–88.1%), respectively. The estimated 5-year RFS for RLR and LLR were 58.6% (95% CI: 48.6–70.6%) and 38.3% (95% CI: 26.4–55.9%), respectively. In the multivariate Cox regression analysis, RLR (HR: 0.586, 95% CI (0.393–0.874), p = 0.008) emerged as an independent predictor of reducing recurrence rates and enhanced RFS. The operative learning curve indicates that approximately after the 11th case, the learning curve of RLR stabilized and entered a proficient phase.
Conclusions
OS was comparable between RLR and LLR, and while RFS was improved in the RLR group. RLR demonstrates oncological effectiveness and safety for resectable HCC.
Funder
National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Cited by
1 articles.
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1. Pioneering the future of robotic liver surgery;Hepatobiliary Surgery and Nutrition;2024-08