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.