Long-term Efficacy Of Laparoscopic Vs Open Liver Resection For Small Hepatocellular Carcinoma And Analysis Of Prognostic Factors

Objective:To compare the efficacy of laparoscopic hepatectomy and open hepatectomy in the treatment of primary small hepatocellular carcinoma and analysis of prognostic factorsMethods:Between January 1,2012 and December 31,2015,one hundred and twelve patients underwent curative hepatectomy for a single HCC 3cm at Hunan Provincial People’s Hospital.The clinical data of 112 patients were retrospectively analyzed.Of these patients,fifty-one underwent laparoscopic liver resection(LLR group)and sixty-one patients underwent open liver resection(OLR group).The 1-,2-,3-year recurrence-free survival(RFS)and overall survival rates(OS)of the two groups were compared.ResuIt:The 1-,2-,3-year OS were 95.1%,88.5%and 83.60%in the OLR group and 98.0%,90.2%,84.3%in the LLR group,respectively.The corresponding 1-,2-,3-year RFS were 83.6%,68.9%and 59.0%in OLR group and 84.3%,70.6%and 64.7%in the LLR group.In multivariate analysis,tumor size and presence of microvascular invasion,tumor differentiation were independent prognostic factors for OS,While the presence of cirrhosis,microvascular invasion and,tumor size more than 2cm were independent risk factors of RFS.Conclusion:For primary small hepatocellular carcinoma with diameter less than 3cm,there is no significant difference in terms of survival between laparoscopic liver resection and open liver resection.laparoscopic liver resection was not a prognostic factor for OS.The tumor size,microvascular invasion and tumor differentiation were more significant.