Robotic vs. Open Liver Resection for Hepatocellular Carcinoma

With the adoption of laparoscopic and robotically assisted procedures, interest in minimally invasive surgery has increased across the spectrum of gastrointestinal malignancies.

Investigators in Europe and the U.S. now report results of a retrospective, multicenter, cohort study that compared outcomes between robotic liver rection (RLR) and open liver resection (OLR) in 212 hepatocellular carcinoma (HCC) patients with similar demographics after propensity-score matching (median age, 67–69 years; 85%–88% male; Child-Pugh-Turcotte A status, 100–101; Charlson Comorbidity Index, 6; median tumor size, 30–35 mm).

Results were as follows:

• Operative times were longer with RLR than with OLR (median 295 vs. 200 min; P<0.001).
• Hospital stays were shorter with RLR than with OLR (median 4 vs. 10 days; P<0.001).
• Rates of severe complications (grades 3–4) were lower with RLR than with OLR (2.8% vs.11.3%; P=0.029).
• Resection margins were similar with RLR and OLR (8mm and 9mm).
• R0 resection rates were similar with RLR and OLR (99% and 100%).
• Estimated 24-month overall survival was similar with RLR and OLR (86.9% and 83.8%).