Minimally Invasive Hepatectomy Shows Superior Survival in Early to Intermediate HCC: Study

A new study published in the Journal of Hepatocellular Carcinoma showed that minimally invasive hepatectomy (MIH) offers better overall survival outcomes for early- or intermediate-stage hepatocellular carcinoma (HCC) when compared to open hepatectomy (OH) and radiofrequency ablation (RFA).

Hepatocellular carcinoma is responsible for more than 70% of primary liver cancers and has become increasingly common in recent decades. However, for the population with early-stage HCC, curative-intent therapies such as radiofrequency ablation (RFA) and surgical resection continue to be the mainstay. The Barcelona Clinic Liver Cancer (BCLC) consensus states that RFA, open hepatectomy (OH), and surgical resection (minimally invasive hepatectomy, MIH) are the curative treatments for individuals with early-stage HCC.

Therefore, to assess the efficacy of MIH in terms of survival outcomes for patients with early and resectable intermediate-stage HCC, Chen HK and team carried out this retrospective cohort study by examining a sizable, multi-institutional electronic health records (EHR) database containing records of roughly 1.3 million individuals.

The patients 20 years of age and older who had recently had MIH for HCC and had Barcelona Clinic Liver Cancer (BCLC) classifications of stage 0, A, or B between 2010 and 2019 were included in this retrospective cohort analysis. As comparison groups, two cohorts of patients undergoing open hepatectomy and those undergoing radiofrequency ablation were chosen based on their 1:1 propensity scores. This research compared patients who had OH and those who received RFA as a control analysis, assuming that the OH group would do better in terms of survival than the RFA group.

In all, 382 matched patients getting MIH or RFA and 555 matched patients receiving MIH or OH were included. The MIH group was linked to similar PFS and greater overall survival (OS) than the OH group. This study discovered that the MIH group was linked to improved OS and better PFS when compared to the RFA group.

A number of subgroup analyses (such as age groups, BCLC stages, and hospital levels) and sensitivity analyses (such as limiting the research period to the most recent five years (2015–2019)) yielded consistent results. The robustness of the primary findings was validated by the control analysis (OH group versus RFA group). Overall, MIH was linked to improved OS and PFS outcomes compared to RFA in patients with early or resectable intermediate-stage HCC.

Source:

Chen, H.-K., Chang, K.-C., Shao, S.-C., Soong, R.-S., Chen, Y.-C., Wu, C.-F., Wu, T.-H., Chou, T.-S., Chan, S.-C., & Lai, E. (2025). Effectiveness of minimally invasive hepatectomy in patients with early or intermediate-stage hepatocellular carcinoma: A multi-institutional cohort study in an Asian population. Journal of Hepatocellular Carcinoma, 12, 879–890. https://doi.org/10.2147/jhc.s485171