Laparoscopic and open liver resection for hepatocellular carcinoma with type 2 diabetes mellitus: multicenter propensity score-matched study

• Published in: Hepatology international 2023-10, Vol.17 (5), p.1251-1264
• Main Authors: Yang, Shi-Ye, Feng, Jin-Kai, Yan, Mao-Lin, Guo, Lei, Duan, Yun-Fei, Ye, Jia-Zhou, Liu, Zong-Han, Xiang, Yan-Jun, Xu, Li, Xue, Jie, Shi, Jie, Lau, Wan Yee, Cheng, Shu-Qun, Guo, Wei-Xing
• Format: Article
• Language: English
• Subjects: Carcinoma, Hepatocellular - pathology; Colorectal Surgery; Complications; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Health care facilities; Hepatectomy - methods; Hepatocellular carcinoma; Hepatology; Humans; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Length of Stay; Liver; Liver cancer; Liver Neoplasms - pathology; Medicine; Medicine & Public Health; Original Article; Patients; Postoperative; Postoperative Complications - epidemiology; Propensity Score; Rank tests; Retrospective Studies; Subgroups; Surgery; Survival; Treatment Outcome
• ISSN: 1936-0533; 1936-0541
• DOI: 10.1007/s12072-023-10492-2

Purpose This study aimed at analyzing and comparing the perioperative results and long-term oncological outcomes of hepatocellular carcinoma (HCC) patients with type 2 diabetes mellitus (T2DM) treated with laparoscopic (LLR) versus open liver resection (OLR). Methods Clinicopathological data of HCC patients with T2DM who underwent LLR or OLR as initial treatment from four medical centers were retrospectively reviewed. The survival outcomes of patients who underwent laparoscopic liver resection (LLR) were compared with those of patients who underwent open liver resection (OLR). Using the Kaplan–Meier method, survival curves for the two groups of patients were generated, and the log-rank test was used to compare survival differences. Propensity score matching (PSM) analysis was used to match patients of the LLR and OLR groups in a 1:1 ratio. Results 230 HCC patients with T2DM were enrolled, including 101 patients in the LLR group and 129 patients in the OLR group. After PSM, 90 patients were matched in each of the study group. Compared with the OLR group, the LLR group had less blood loss, a shorter hospitalization and fewer postoperative complications. The LLR group had a significantly better overall survival (OS) and recurrence-free survival (RFS) than the OLR group before and after PSM. Subgroup analysis demonstrated that HCC patients with T2DM had survival benefits from LLR regardless of the course of T2DM. Conclusions Laparoscopic liver resection for HCC patients with T2DM can be safely performed with favorable perioperative and long-term oncological outcomes at high-volume liver cancer centers, regardless of the course of T2DM.