Observational studySurgical endoscopy2025
Recurrence and survival after robotic vs laparoscopic liver resection in very-early to early-stage (BCLC 0-A) hepatocellular carcinoma.
Observational study in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Oncological Adequacy of R1 Vascular Margin in Minimally Invasive Liver Surgery for Hepatocellular Carcinoma and Colorectal Liver Metastases: A Meta-analysis.Annals of surgical oncology · 2026Pooled it
- Evaluating robotic vs. laparoscopic liver resection for BCLC stage 0-I hepatocellular carcinoma: a meta-analysis of propensity score-matched studies on perioperative outcomes.Journal of robotic surgery · 2025Pooled it
- A meta-analytic and systematic review to compare perioperative outcomes and prognosis between robotic and conventional (laparoscopic or open) liver resection in hepatocellular carcinoma cases.World journal of surgical oncology · 2025Pooled it
- Robotic versus laparoscopic surgery in hepatobiliary procedures: a scoping review.BMC surgery · 2026Article
- Transarterial Chemoembolization in Hepatocellular Carcinoma: Lessons from a 10-Year Real-World Retrospective Study.Journal of hepatocellular carcinoma · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRobotic (RLR) and laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) provide similar short-term outcomes, but data focused on recurrence and survival are still lacking. We hypothesized non-inferior oncologic results of RLR compared to LLR for HCC of stage BCLC 0-A.
methodsRLRs and LLRs on patients with HCC of stage BCLC 0-A and preserved liver function (Child A or B if cirrhosis) were retrospectively reviewed. Propensity score matching (PSM) was used to mitigate selection bias. The primary endpoints were recurrence-free (RFS) and overall survival (OS); secondary endpoints were incidence, pattern, and treatment of recurrences.
resultsAfter 1:1 PSM, two groups (RLR = 68; LLR = 68) of patients with similar characteristics, liver function and HCC features were obtained: median age 71-years, males 73.5%, underlying cirrhosis 91.2% (Child A, 96.8%, MELD ≤ 9, 96.0%), portal hypertension 22.1%, single-HCC 90.4%. Two- and 5-year RFS were 78.0 vs 59.0% and 54.0 vs 53.0% (p = 0.107), while OS was 97.0 vs 90.0% and 87.0 vs 90.0% (p = 0.951) for RLR vs LLR, respectively. Incidence of HCC recurrence was similar (35.3 vs 39.7%; p = 0.723). Recurrences developed mostly within the liver (29.4 vs 30.9%; p = 1.000) and within 2 years after hepatectomy (19.1 vs 32.4%, p = 0.116) in RLR vs LLRs. Curative-intent treatment of recurrences did not differ (liver transplantation 19.6%, redo-resection 15.7%, locoregional treatments 52.9%) except for a tendency toward more redo-resections for recurrences after RLR.
conclusionsOncologic outcomes of RLR were not inferior to those of LLR in selected HCC patients of stage BCLC 0-A with underlying cirrhosis. Both techniques guaranteed similar salvageability in case of HCC recurrence.
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