Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, 610041, Sichuan Province, China.
Surg Endosc. 2024 Nov;38(11):6456-6463. doi: 10.1007/s00464-024-11239-2. Epub 2024 Sep 12.
The impact of metabolic dysfunction-associated fatty liver disease (MAFLD) on laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) remains unclear. This study aimed to compare the outcomes of LLR for MAFLD-HCC and Non-MAFLD-HCC.
Patients with HCC who received LLR between October 2017 and July 2021 were enrolled. Inverse probability of treatment weighting (IPTW) was used to generate adjusted comparisons. Both short- and long-term outcomes were evaluated accordingly.
A total of 887 patients were enrolled, with 140 in MAFLD group and 747 in Non-MAFLD group. After IPTW adjustment, baseline factors were well matched. The MAFLD group was associated with more blood loss (210 vs 150 ml, p = 0.022), but with similar postoperative hospital stays and complication rates. The 1- and 3-year overall survival rates were 97.4% and 92.5% in MAFLD group, and 97.5% and 88.3% in Non-MAFLD group, respectively (p = 0.14). The 1- and 3-year disease-free survival rates were 84.8% and 62.9% in MAFLD group, and 80.2% and 58.8% in Non-MAFLD group, respectively (p = 0.31).
LLR for MAFLD-HCC was associated with more blood loss but with comparable postoperative recovery and long-term survival compared with Non-MAFLD-HCC patients. LLR is feasible and safe for HCC patients with MAFLD background.
代谢相关脂肪性肝病（MAFLD）对肝细胞癌（HCC）腹腔镜肝切除术（LLR）的影响尚不清楚。本研究旨在比较 MAFLD-HCC 和非 MAFLD-HCC 患者接受 LLR 的结果。
纳入 2017 年 10 月至 2021 年 7 月期间接受 LLR 的 HCC 患者。采用逆概率治疗加权法（IPTW）生成调整后的比较。并相应评估短期和长期结果。
共纳入 887 例患者，MAFLD 组 140 例，非 MAFLD 组 747 例。经 IPTW 调整后，基线因素匹配良好。MAFLD 组出血量较多（210 与 150ml，p=0.022），但术后住院时间和并发症发生率相似。MAFLD 组 1 年和 3 年总生存率分别为 97.4%和 92.5%，非 MAFLD 组分别为 97.5%和 88.3%（p=0.14）。MAFLD 组 1 年和 3 年无病生存率分别为 84.8%和 62.9%，非 MAFLD 组分别为 80.2%和 58.8%（p=0.31）。
与非 MAFLD-HCC 患者相比，MAFLD-HCC 患者行 LLR 出血量较多，但术后恢复和长期生存相当。对于 MAFLD 背景下的 HCC 患者，LLR 是可行且安全的。
