Evidence map›Paper›PMID 40172781›Full record

ArticleUpdates in surgery2025

Laparoscopic versus open liver resection for large (≥ 5 cm) hepatocellular carcinoma in elderly patients: a multicenter propensity score-matched study.

Gianluca Cassese, Fabio Giannone, Federica Cipriani, Antonio Cubisino, Rami Rhaiem, Bruno Branciforte, Edoardo Maria Muttillo, Bader Al Taweel, Alessandro Tropea, Emanuele Felli and 12 more

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Gianluca CasseseDivision of Hepato-Pancreato-Biliary, Department of Research and Innovation (DAIRI), Oncologic and Robotic Surgery, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.ORCID http://orcid.org/0000-0001-9185-2054
Fabio GiannoneDivision of Hepato-Pancreato-Biliary, Department of Research and Innovation (DAIRI), Oncologic and Robotic Surgery, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Federica CiprianiHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Antonio CubisinoDepartment of HPB Surgery and Liver Transplantation, Beaujon Hospital, APHP, University of Paris Cité, Clichy, France.
Rami RhaiemDepartment of Oncological Digestive Surgery, Hepatobiliary and Pancreatic Surgery Unit, University Reims Champagne-Ardenne, Reims, France.
Bruno BranciforteDivision of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Center - IRCCS, Humanitas University, Rozzano, Milan, Italy.
Edoardo Maria MuttilloSurgical and Medical Department of Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Bader Al TaweelDivision of HBP Surgery and Transplantation, Department of Surgery, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France.
Alessandro TropeaDepartment for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, UPMC (University of Poittsburgh Medical Center), Palermo, Italy.
Emanuele FelliLiver Transplant and Surgery Department, Trousseau Hospital, Tours, France.
Raffaele BrustiaDepartment of Digestive and Hepato-Pancreatic-Biliary Surgery, AP-HP, Hôpital Henri-Mondor, Paris Est Créteil University, UPEC, Créteil, France.
Daniele SommacaleDepartment of Digestive and Hepato-Pancreatic-Biliary Surgery, AP-HP, Hôpital Henri-Mondor, Paris Est Créteil University, UPEC, Créteil, France.
Ephrem SalameLiver Transplant and Surgery Department, Trousseau Hospital, Tours, France.
Patrick PessauxDepartment of Health Sciences, University of Eastern Piedmont "Amedeo Avogadro", Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Salvatore GruttadauriaDepartment for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, UPMC (University of Poittsburgh Medical Center), Palermo, Italy.
Gian Luca GraziHepatobiliary Surgery Unit, Regina Elena Cancer Institute, Rome, Italy.
Guido TorzilliDepartment of Oncological Digestive Surgery, Hepatobiliary and Pancreatic Surgery Unit, University Reims Champagne-Ardenne, Reims, France.
Tullio PiardiDepartment of Oncological Digestive Surgery, Hepatobiliary and Pancreatic Surgery Unit, University Reims Champagne-Ardenne, Reims, France.
Ho-Seong HanDivision of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Mickael LesurtelDepartment of HPB Surgery and Liver Transplantation, Beaujon Hospital, APHP, University of Paris Cité, Clichy, France.
Luca AldrighettiHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Fabrizio PanaroDivision of Hepato-Pancreato-Biliary, Department of Research and Innovation (DAIRI), Oncologic and Robotic Surgery, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. fabrizio.panaro@uniupo.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The outcomes of laparoscopic liver resection (LLR) for large (≥ 5 cm) hepatocellular carcinoma (HCC) in elderly (≥ 70 years old) patients have not been deeply investigated so far. The aim of the study was to compare short- and long-term results of LLR vs. open liver resection (OLR) in this setting. Data regarding all patients undergoing liver resection for large HCC were retrospectively collected from referral European and Asian HPB centers. The cases were propensity score matched for age, BMI, center, underlying liver cirrhosis, comorbidities, extent of the resection, tumor size, and numbers. After matching 363 patients with large HCC aged ≥ 70 years old, two cohorts of 90 patients were compared. The laparoscopic group showed a shorter median length of hospital stay (7 vs 9 days, p = 0.01), with a lower rate of R1 resections (4.4% vs 13.3%, p = 0.03). No statistically significant differences were found in the median operative time (p = 0.34), intraoperative blood transfusions (p = 1.00), severe postoperative complications (p = 0.29), postoperative hemorrhage (p = 0.30), post-hepatectomy liver failure (p = 0.47), or in-hospital mortality (p = 0.31). After a median follow-up of 35 months (95% CI 27.6-42.3), there were no statistically significant differences in both overall survival (p = 0.28) and disease-free survival (p = 0.42). LLR was safe and effective in selected cases of large HCC in elderly patients and was proven to shorten median hospital stay and to reduce the R1 rates, without affecting both short- and long-term survival outcomes.

Indexed as

Carcinoma, HepatocellularHepatectomyLaparoscopyLiver NeoplasmsAgedAged, 80 and overFemaleHumansLength of StayMalePostoperative ComplicationsPropensity ScoreRetrospective StudiesTreatment OutcomeElderly patientsLarge hepatocellular carcinomaMinimally invasive liver surgery

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.