Long-term survival outcome of laparoscopic liver resection for hepatocellular carcinoma

Table 1 Summary of comparative studies: Operative outcomes

Ref.	Blood loss in mL /transfused %			Resection margin in mm			R0 resection rate %
	LLR	OLR	P	LLR	OLR	P	LLR	OLR	P
Belli et al[5]	297	580	< 0.001				100	93.6	0.057
Tranchart et al[6]	364.3	723.7	< 0.0001	10.4	10.6	NS
Lee et al[7]	150	240	NS	1.8	1.05	0.016	97	98	NS
Ahn et al[8]	350	355	NS	17	13	NS
Memeo et al[9]	200	200	NS	10	6	0.02
Lee et al[10]	300	700	0.004	13	10	0.25
Yoon et al[11]	3.4%	7.5%	0.04	2.03	1.12	0.01
Xiao et al[12]	272	450	0.001				100	98	NS
Sposito et al[13]			NS	6	5	NS	98	98	NS
Cheung et al[14]	100	300	< 0.001				100	93.1	NS
Ryu et al[15]							95	83	NS
Rhu et al[16]	13%	2%	NS	13	12	NS
Guro et al[17]	1543	1248					97.6	94.6	NS
El-Gendi et al[18]	230	250	NS				100	100	NS
Inoue et al[19]	100	380	< 0.0001	7	5	NS
Kim et al[20]	300	250	NS	13	15	NS
Deng et al[21]	150	380	< 0.001				98	90	NS
Wu et al[22]	150	250	NS
Tsai et al[23]	363	839	< 0.001	5	5.2	NS
Di Sandro et al[24]	150	200	0.007	5	5	NS
Li et al[25]	328	396	NS
Kim et al[26]	152	245		8.5	8.4	NS
Chen et al[27]	300	500	< 0.1				97	100	NS
Untereiner et al[28]	150	250	NS				91	85	NS
Yoon et al[29]	226	251					98	98
Peng et al[30]	200	300	NS				100	100	NS
Yamamoto et al[31]	87	223		3	3	NS
Lee et al[32]	19%	28%	NS	9	16.5	NS
Navarro et al[33]	234	454	0.021				100	100	NS
Delvecchio et al[34]	13%	25%	NS				95	87	NS
Ho et al[35]	500	725	NS	5	3	0.043	91	91	NS

LLR: Laparoscopic liver resection; NS: Statistically not significant; OLR: Open liver resection.

Table 2 Summary of comparative studies: Baseline clinical-pathological features of both treatment groups

Ref.	Difference between study groups	ICG, %		Child A/B/C, %		Tumor size in cm				Microvascular invasion, %
		LLR	OLR	LLR	OLR	LLR	+/- SD/95%CI	OLR	+/- SD/95%CI	LLR	OLR
Belli et al[5]	Tumor size, AFP level, margin width			91/9/0	93.6/6.4/0	3.8	+/-1.3	6	+/-2.3	37	39.2
Tranchart et al[6]						3.6	+/-1.75	3.7	+/-2.1	33.3	35.7
Lee et al[7]	Cirrhosis, previous abdominal surgery, margin width					2.5	1.5-9	2.9	1.2-9
Ahn et al[8]		14.5	13.1			2.6	+/-1.5	2.8	+/-1.2	15.7	19.6
Memeo et al[9]	Margin width			98/2/0	96/4/0	3.2	0.9-11	3.7	0.1-15
Lee et al[10]	Margin width			97.6/2.4/0	97.6/2.4/0	5.4	2-16	4.4	2-14	52.5	43.5
Yoon et al[11]	Margin width	12.1	12.4			2.87	0.7-4.9	3.04	0.2-4.9
Xiao et al[12]				95/5/0	96.5/3.5/0	4.22	+/-2.05	4.3	+/-1.49
Sposito et al[13]		15	15	98/2/0	95/5/0	2.6	1-6.5	2.2	1-8.5	56	37
Cheung et al[14]	Age			100/0/0	96.6/3.4/0	3	1.2-5	3.5	1.5-8.5
Ryu et al[15]		11.9	14			3.9	1.1-17	4.9	1-14.5	30	40
Rhu et al[16]				37.7/0/0	37.1/0/0	3.1	+/-5.7	3.1	+/-1.7	56.6	58.8
Guro et al[17]	Cirrhosis, tumor size			95/2.4/2.4	88/9.9/7.2	4.1	+/-2.4	6.3	+/-3.8
El-Gendi et al[18]				100/0/0	100/0/0	3.3	+/-0.57	3.4	0.59	60	68
Inoue et al[19]				89/11/0	100/0/0	2.5		2.6		12	13
Kim et al[20]		9.3	8			2.8		2.8		25	23
Deng et al[21]	Procedure type			100/0/0	100/0/0	2.5		2.8		10.2	16.6
Wu et al[22]						3.5	0.9-12.5	3.5	0.8-11.3	38.4	41.9
Tsai et al[23]	Procedure magnitude, tumor size			93/7/0	98/2/0	3.9	+/-2.6	7.2	+/-5.3
Di Sandro et al[24]				87/13/0	84/16/0	2.5	2-3.0	2.5	1.8-3.3	29.3	29.3
Li et al[25]	Tumor size					4	+/-2	5.7	+/-3	17	30
Kim et al[26]		10.4	12.8			3	+/-2.1	3.2	+/-3.14	22.2	27.8
Chen et al[27]		6.9	6.9			7.3	+/-3.4	7.6	+/-4.2	37	32
Untereiner et al[28]				64/0/0	73/0/0	3	2.1-4.9	3	2.3-5
Yoon et al[29]	ASA class, medical disease	13.6	14	66.8/0/0	65.4/0/0	2.83	1.28	2.9	1.31	14.3	15.7
Peng et al[30]				94/6/0	91/9/0	4.8	2-8.5	5.5	2-8.5	30	30
Yamamoto et al[31]				88/22/0	84/16/0	1.7	1.2-4.2	2	0.7-9.9
Lee et al[32]				90/10/0	91/9/0	2.5	7-14.5	2.6	1.1-14.5	8.6	8.6
Navarro et al[33]						3.5	8.5	3.3	8.1	51.2	51.2
Delvecchio et al[34]				97/3/0	98/2/0	4	3.0-16	7	1.5-14
Ho et al[35]	Hepatitis C carrier status margin width			100/0/0	92/8/0	3.5	2-5	4	3-5	28.9	30

AFP: Alpha-fetoprotein; ASA: American Society of Anesthesiologists; CI: Confidence interval; ICG: Indocyanine green retention at 15 min; LLR: Laparoscopic liver resection; OLR: Open liver resection; SD: Standard deviation.

Table 3 Summary of comparative studies: Study design

Ref.	Year	Number of patients		Matching	Study population
		LLR	OLR		Demographic	Tumor	Cirrhosis	Procedure
Belli et al[5]	2009	54	125	No		< 5 cm, anterolaterally located
Tranchart et al[6]	2010	42	42	Yes
Lee et al[7]	2011	33	50	Yes				Minor resection
Ahn et al[8]	2014	51	51	Yes		Solitary
Memeo et al[9]	2014	45	45	Yes			Cirrhosis
Lee et al[10]	2015	43	86	Yes
Yoon et al[11]	2015	58	174	Yes		< 5 cm
Xiao et al[12]	2015	41	86	No		Posterosuperior
Sposito et al[13]	2016	43	43	Yes			Cirrhosis	Minor resection
Cheung et al[14]	2016	24	29	Yes				Left lateral sectionectomy
Ryu et al[15]	2018	40	30	No				Anatomical resection
Rhu et al[16]	2018	58	133	Yes				Right posterior sectionectomy
Guro et al[17]	2018	67	110	No				Major hepatectomy
El-Gendi et al[18]	2018	25	25	Randomized		< 5 cm	Child A
Inoue et al[19]	2018	61	175	Yes		< 5 cm		Parenchymal sparing hepatectomy
Kim et al[20]	2018	37	37	Yes				Left hepatectomy
Deng et al[21]	2018	157	157	Yes
Wu et al[22]	2019	86	86	Yes			Cirrhosis
Tsai et al[23]	2019	153	160	Yes
Di Sandro et al[24]	2018	75	75	Yes			Cirrhosis	Minor hepatectomy
Li et al[25]	2019	41	307	Yes				Mesohepatectomy
Kim et al[26]	2018	18	36	Yes		Central
Chen et al[27]	2019	38	38	Yes				Right hepatectomy
Untereiner et al[28]	2019	33	33	Yes
Yoon et al[29]	2020	217	434	Yes
Peng et al[30]	2019	33	33	Yes		Multiple
Yamamoto et al[31]	2020	58	197	Yes			Cirrhosis
Lee et al[32]	2021	58	110	Yes
Navarro et al[33]	2021	106	299	Yes				Major hepatectomy
Delvecchio et al[34]	2021	38	84	Yes	Elderly			Major hepatectomy
Ho et al[35]	2021	45	90	Yes

LLR: Laparoscopic liver resection; OLR: Open liver resection.

Table 4 Summary of comparative studies: Long-term oncological outcomes

Ref.	1-year OS, %			3-year OS, %			5-year OS, %			1-year DFS, %			3-year DFS, %			5-year DFS, %
	LLR	OLR	P	LLR	OLR	P	LLR	OLR	P	LLR	OLR	P	LLR	OLR	P	LLR	OLR	P
Belli et al[5]	94	85	NS	67	53	NS				78	79	NS	52	52	NS
Tranchart et al[6]	93.1	81.8	NS	74.4	73	NS	59.5	47.4	NS	81.6	70.2	NS	60.9	54.3	NS	45.6	37.2	NS
Lee et al[7]	86.9	98	NS	81.8	80.6	NS	76	76.1	NS	78.8	69.2	NS	51	55.9	NS	45.3	55.9	NS
Ahn et al[8]							80.1	85.7	NS							67.8	54.8	NS
Memeo et al[9]	88	63	NS				59	44	NS	80	60	NS				19	23	NS
Lee et al[10]	95.3	93.9	NS	89.7	89.5	NS	89.7	87.3	NS	60.5	81.5	NS	60.3	66.7	NS	60.3	58.6	NS
Yoon et al[11]	95	98	NS	86	84	NS				82	88	NS	63	62	NS
Xiao et al[12]	95.1	89.5	NS	78	76.7	NS				87.8	82.6	NS	70.7	68.6	NS
Sposito et al[13]				75	79	NS	38	46	NS				41	44	NS	25	11	NS
Cheung et al[14]	100	93	NS	85.6	84.1	NS	69.1	77.6	NS	95	69.2	NS	72.8	61.5	NS	51.8	61.5	NS
Ryu et al[15]	89.9	89.9	NS	84.7	68	NS	70.9	63.1	NS	79.5	72.4	NS	58	56.1	NS	42.5	50.4	NS
Rhu et al[16]	96.8	96.8	NS	94.5	94.5	NS	94.5	94.5	NS	77.8	77.8	NS	68.3	68.3	NS	62.5	62.5	NS
Guro et al[17]							77.3	60.2	NS							50.8	40.1	NS
El-Gendi et al[18]										88	84	NS	58.7	54	NS
Inoue et al[19]	97.8	87.9	NS	78.8	70.6	NS				83.8	75	NS	57.5	54.8	NS
Kim et al[20]				93.9	93.8								79.6	91.1	NS
Deng et al[21]	96.2	96.8	NS	72.6	73.4	NS	45.3	46.9	NS	90.5	91.7	NS	53.7	54.4	NS	24.6	19.9	NS
Wu et al[22]	93	81.4	NS	81.4	75.5	NS	69.8	62.8	NS	75.6	69.8	NS	60.5	53.5	NS	44.2	38.4	NS
Tsai et al[23]	90.3	85	0.002	82.9	63.6	0.002	78.1	57.6	0.002	72.9	60.8	NS	49.2	43	NS	37.9	31	NS
Di Sandro et al[24]				68	76								44	44	NS
Li et al[25]	96.3	95.3	NS	68.4	90.5	NS				84	87.2	NS	36	59.7	NS
Kim et al[26]	94.4	100	NS	94.4	92.9	NS				93.8	76.5	NS	56.3	41.3	NS
Chen et al[27]				69.8	74	NS							51.6	57.8	NS
Untereiner et al[28]				78	79	NS							72	58.6	NS
Yoon et al[29]	98.1	93.8	NS	87	90.8	NS	78.6	84.3	NS	81	85.3	NS	62	64.7	NS	49.1	56.2	NS
Peng et al[30]	95.8	92.8		77	77	NS				71.9	79.1	NS	51.4	46.2	NS
Yamamoto et al[31]				82	78.4	NS	58.9	62.3	NS				52.6	40.3	NS	24	24.1	NS
Lee et al[32]	96.6	92.8	NS	73.3	93.1	NS	88.8	76.1	NS	84.4	64	NS	60.2	93.1	NS	67.4	63.9	NS
Navarro et al[33]							90	90	NS							58	40	NS
Delvecchio et al[34]	100	95	NS	100	88	NS	77	75	NS	67	79	NS	44	54	NS	29	46	NS
Ho et al[35]	95.6	87.5	0.036	84.9	70.3	0.036	84.9	61.1	0.036	80.0	73.3	NS	40.0	41.1	NS	20.0	22.2	NS

DFS: Disease-free survival; LLR: Laparoscopic liver resection; NS: Statistically not significant; OLR: Open liver resection; OS: Overall survival.