Background: The incidence of hepatocellular carcinoma (HCC) in elderly patients is increasing worldwide. Although open hepatectomy (OH) yields acceptable outcomes, high morbidity rate is concerned. Laparoscopic hepatectomy (LH) has evolved to improve perioperative outcomes. However, comparative study between both techniques for elderly patients with HCC is scarce. Objective: This study aimed to compare outcomes between LH and OH specifically. Methods: HCC patients aged ≥70 years after hepatectomy (2003–2018) were included. The propensity score matching (PSM) and comparative analyses between groups were performed. Results: After PSM, there were 41 patients in each group with similar demographics, radiographic tumor characteristics, cirrhotic status, and extent of resection. The LH group had a shorter hospital stay (7 vs. 11 days, p = 0.002) compared with the OH group. The completeness of resection and complication rates were not statistically different between groups. The 5-year overall survival and recurrence-free survival rates were 86.7 and 43.4% in the LH group and 62.2 and 30.8% in the OH group (p = 0.221 and 0.500). Conclusion: Our study confirmed the operative and oncological safety of LH in elderly HCC patients with improved perioperative outcomes compared with OH.

中文翻译：

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腹腔镜与开腹肝切除术治疗老年肝细胞癌：单一机构倾向评分匹配比较

背景：全球老年患者肝细胞癌（HCC）的发病率正在增加。尽管开放式肝切除术 (OH) 产生了可接受的结果，但仍需关注高发病率。腹腔镜肝切除术 (LH) 已经发展到可以改善围手术期结果。然而，这两种技术对老年 HCC 患者的比较研究很少。目的：本研究旨在专门比较 LH 和 OH 之间的结果。方法：纳入肝切除术后≥70岁的HCC患者（2003-2018）。进行了倾向评分匹配（PSM）和组间比较分析。结果：PSM 后，每组中有 41 名患者具有相似的人口统计学特征、影像学肿瘤特征、肝硬化状态和切除范围。LH 组的住院时间较短（7 天对 11 天，p = 0。002) 与 OH 组相比。切除的完整性和并发症发生率在组间没有统计学差异。LH 组的 5 年总生存率和无复发生存率分别为 86.7% 和 43.4%，OH 组为 62.2% 和 30.8%（p = 0.221 和 0.500）。结论：我们的研究证实了 LH 在老年 HCC 患者中的手术和肿瘤学安全性，与 OH 相比，围手术期结果有所改善。