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Long-term outcomes ...
Long-term outcomes of laparoscopic liver resection for hepatocellular carcinoma : A propensity score matched analysis of a high-volume North American center
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- Ivanics, Tommy (author)
- Uppsala universitet,Gastrointestinalkirurgi,Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI 48202 USA
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- Claasen, Marco Paw (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Med Ctr, Dept Surg, Erasmus MC, Rotterdam, Netherlands.
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- Patel, Madhukar S. (author)
- Univ Texas Southwestern Med Ctr Dallas, Dept Surg, Div Surg Transplantat, Dallas, TX USA.
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- Rajendran, Luckshi (author)
- Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.
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- Shwaartz, Chaya (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Raschzok, Nathanael (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Yoon, Peter (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Perez, Carla F. Murillo (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Toronto Western & Gen Hosp, Toronto Ctr Liver Dis, Toronto, ON, Canada.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada.
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- Hansen, Bettina E. (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Toronto Western & Gen Hosp, Toronto Ctr Liver Dis, Toronto, ON, Canada.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada.
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- Muaddi, Hala (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.
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- Moulton, Carol-Anne (author)
- Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.
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- Reichman, Trevor (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Ghanekar, Anand (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Gallinger, Steve (author)
- Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.
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- McGilvray, Ian (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.
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- Cleary, Sean P. (author)
- Mayo Clin, Div Hepatobiliary & Pancreat Surg, Rochester, MN USA.
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- Sapisochin, Gonzalo (author)
- Univ Hlth Network Toronto, Multiorgan Transplant Program, Toronto, ON, Canada.;Univ Hlth Network, Div Gen Surg, Toronto, ON, Canada.
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: Surgery. - : Elsevier. - 0039-6060 .- 1532-7361. ; 171:4, s. 982-991
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Laparoscopic liver resections for malignancy are increasing worldwide, and yet data from North America are lacking. We aimed to assess the long-term outcomes of patients undergoing laparoscopic liver resection and open liver resection as a treatment for hepatocellular carcinoma.Methods: Patients undergoing liver resection for hepatocellular carcinoma between January 2008 and December 2019 were retrospectively studied. A propensity score matching was performed using patient demographics, laboratory parameters, etiology of liver disease, liver function, and tumor characteristics. Primary outcomes included overall survival and cumulative incidence of recurrence. Kaplan-Meier and competing risk cumulative incidence were used for survival analyses. Multivariable Cox regression and Fine-Gray proportional hazard regression were performed to determine hazard for death and recurrence, respectively.Results: Three hundred and ninety-one patients were identified (laparoscopic liver resection: 110; open liver resection: 281). After propensity score matching, 149 patients remained (laparoscopic liver resection: 57; open liver resection: 92). There were no significant differences between groups with regard to extent of hepatectomy performed and tumor characteristics. The laparoscopic liver resection group experienced a lower proportion of >= Clavien-Dindo grade III complications (14% vs 29%; P = .01). In the matched cohort, the 1-, 3-, and 5-year overall survival rate in the laparoscopic liver resection versus open liver resection group was 90.9%, 79.3%, 70.5% vs 91.3%, 88.5%, 83.1% (P = .26), and the cumulative incidence of recurrence 31.1%, 59.7%, 62.9% vs 18.9%, 40.6%, 49.2% (P = .06), respectively.Conclusion: This study represents the largest single institutional study from North America comparing long-term oncologic outcomes of laparoscopic liver resection and open liver resection as a treatment for primary hepatocellular carcinoma. The combination of reduced short-term complications and equivalent long-term oncologic outcomes favor the laparoscopic approach when feasible.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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- By the author/editor
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Ivanics, Tommy
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Claasen, Marco P ...
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Patel, Madhukar ...
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Rajendran, Lucks ...
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Shwaartz, Chaya
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Raschzok, Nathan ...
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Yoon, Peter
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Perez, Carla F. ...
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Hansen, Bettina ...
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Muaddi, Hala
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Moulton, Carol-A ...
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Reichman, Trevor
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Ghanekar, Anand
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Gallinger, Steve
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McGilvray, Ian
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Cleary, Sean P.
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Sapisochin, Gonz ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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Surgery
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Uppsala University