Patient characteristics
We retrospectively analyzed the data of consecutive cases of newly diagnosed HCC who underwent hepatectomy between January 2013 and December 2019 in Hualien Tzu Chi General Hospital, a tertiary referral center in eastern Taiwan. The preoperative diagnosis of HCC was made based on the results of two sets of noninvasive dynamic imaging in high-risk groups with chronic hepatitis B, chronic hepatitis C, or cirrhosis with or without elevated alpha-fetoprotein (AFP). Postoperative HCC was confirmed by pathological examination of resected specimens in all patients. Patients with a diagnosis of recurrent HCC, prior HCC treatment, or synchronous malignancy were excluded. The patients were divided into the LH and OH groups. Those with tumors at favorable locations were placed into the favorable location group. In the favorable location group, patients were also divided into an open group (F-OH) and laparoscopic group (F-LH). The criteria for inclusion of patients into the open or laparoscopic group depended on the surgeon’s preference, including patient age, liver function, and tumor size, location, and distance to major vessels. This preference adjusts when the surgeon is more adept in laparoscopic interventions. Volumetric evaluation of the tumor was not routinely performed because it was not covered by the National Health Insurance of Taiwan, and most patients could not afford this evaluation. The Makuuchi criteria were used to determine the resection volume[15]. Medical records were retrospectively reviewed for demographic characteristics, perioperative variables, and follow-up outcomes. The primary endpoint was long-term oncologic outcomes, including overall, and disease-free survival. The secondary endpoint was perioperative outcomes. The overall median follow-up duration was 48 months.