Laparoscopic versus open hepatectomy for intrahepatic cholangiocarcinoma: Systematic review and meta-analysis of propensity score-matched studies |
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| Affiliation: | 1. The First Affiliated Hospital, Department of Hepatobiliary Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China;2. The First Affiliated Hospital, Department of Reproductive Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China;3. Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China;4. The First Affiliated Hospital, Department of Education and Training, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China;1. Department of Surgery, Isala Hospital, Zwolle, the Netherlands;2. Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands;3. Department of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands;4. Department of Surgery, Meander Hospital, Amersfoort, the Netherlands;5. Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, Location AMC, the Netherlands;6. Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands;7. Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands;8. Department of Oncological and Gastrointestinal Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands;1. School of Medicine, University of New Mexico (UNM), Albuquerque, NM, USA;2. School of Medicine, New York Medical College (NYMC), Valhalla, NY, USA;3. Department of Neurosurgery, University of New Mexico Hospital (UNMH), Albuquerque, NM, USA;4. Department of Surgery, University of New Mexico, Albuquerque, NM, USA;5. Department of Neurosurgery, Clinical Neuroscience Center, University of Utah, Salt Lake City, UT, USA;1. Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, UK;2. Institute of Cancer Research, London, UK;3. Department of Radiology, The Royal Marsden NHS Foundation Trust, UK;4. Mater Misericordiae University Hospital, Dublin 7, Ireland;5. Portsmouth NHS Trust, UK;6. University College London Hospital NHS Trust, UK;1. Department of Dermatology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Postbus 90203, 1006 BE, Amsterdam, the Netherlands;2. Department of Dermatology, Amsterdam UMC, Univ. of Amsterdam, Postbus 22660, 1100 DD, Amsterdam, the Netherlands;3. Amsterdam Infection & Immunity Institute, Cancer Center, Univ. of Amsterdam, Postbus 22660, 1100 DD, Amsterdam, the Netherlands;4. Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Postbus 90203, 1006 BE, Amsterdam, the Netherlands;5. Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Postbus 90203, 1006 BE, Amsterdam, the Netherlands;6. Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Univ. of Amsterdam, Postbus 22660, 1100 DD, Amsterdam, the Netherlands;1. Center for Gastric Cancer, National Cancer Center, Korea;2. Department of Cancer Control and Population Science, Graduate School of Cancer Science and Policy, National Cancer Center, Korea;3. Department of Surgery and Cancer, Imperial College of London, United Kingdom;4. Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, USA;5. Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan;6. Faculty of Medicine, Hebrew University of Jerusalem, Israel;7. The Department of Surgery, Kaplan Medical Center, Israel;8. Division of Biology and Biological Engineering, California Institute of Technology Pasadena, California, 91125, USA |
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| Abstract: | ObjectiveTo compare the effects of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) on the short-term and long-term outcomes of patients with intrahepatic cholangiocarcinoma (ICC) through a meta-analysis of studies using propensity score-matched cohorts.MethodsThe literature search was conducted in PubMed, Embase, and Cochrane Library databases until August 31, 2022. Meta-analysis of surgical (major morbidity, the length of hospital stay, 90-day postoperative mortality), oncological (R0 resection rate, lymph node dissection rate) and survival outcomes (1-, 3-, and 5-year overall survival and disease-free survival) was performed using a random effects model. Data were summarized as relative risks (RR), mean difference (MD) and hazard ratio (HR) with 95% confidence intervals (95% CI).ResultsSix case-matched studies with 1054 patients were included (LH 518; OH 536). Major morbidity was significantly lower (RR = 0.57, 95% CI = 0.37–0.88, P = 0.01) and the length of hospital stay was significantly shorter (MD = −2.44, 95% CI = −4.19 to −0.69, P = 0.006) in the LH group than in the OH group, but there was no significant difference in 90-day postoperative mortality between the 2 groups. There were no significant differences in R0 resection rate, lymph node dissection rate, 1-, 3-, and 5-year overall survival or disease-free survival between the LH and OH groups.ConclusionsLH has better surgical outcomes and comparable oncological outcomes and survival outcomes than does OH on ICC. Therefore, laparoscopy is at least not inferior to open surgery for intrahepatic cholangiocarcinoma. |
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| Keywords: | Laparoscopic hepatectomy Open hepatectomy Intrahepatic cholangiocarcinoma Systematic review Meta-analysis Propensity score matching |
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