Minimally invasive surgical treatment of hepatocellular carcinoma: long-term outcome

Laparoscopic liver resection for hepatocellular carcinoma (HCC) is still a matter of debate because of the uncertainty of the long-term results and the fear of compromising the oncological resection. Published findings on survival and outcome after laparoscopic liver resection for HCC are scarce still. The aim of the present study was to report the perioperative and long-term outcome of minimally invasive surgical treatment of HCC.

From January 1998 to November 2008, all patients with HCC who underwent laparoscopic liver resection in our unit were included. A prospectively collected database was analyzed retrospectively. Perioperative outcome included procedure-related morbidity and mortality. Long-term outcome included 5-year overall survival and disease-free survival.

During the study period, 30 consecutive patients with HCC underwent laparoscopic liver resection (hand-assisted laparoscopic liver resection, n = 22; total laparoscopic liver resection, n = 7; converted to open approach, n = 1). The mean tumor size was 2.8 cm. The mean operating time was 139.4 min, and 90% of patients had R0 resection and 10% of patients had R1 resection. The hospital mortality and morbidity rates were 0 and 20%, respectively. The mean hospital stay was 7.4 days. For those patients (n = 22) with a minimal follow-up of 24 months, the 5-year overall and disease-free survival rates were 50 and 36%, respectively. No port site recurrence occurred.

This study showed that laparoscopic liver resection for HCC was feasible and safe in selected patients. The long-term survival was also favorable.