Robotic vs. open liver resection after neoadjuvant therapy for hepatocellular carcinoma: a propensity score-matched analysis of short- and long-term outcomes.

BACKGROUND

Neoadjuvant therapy is recommended for hepatocellular carcinoma at advanced stages. It is unknown whether robotic liver resection (RLR) is superior to open liver resection (OLR) after neoadjuvant therapy.

METHODS

We analyzed consecutive RLR and OLR patients from December 2020 to December 2023. Patient variables, short- and long-term outcomes were compared. A respective 1:3 propensity score-matched (PSM) analysis was performed between RLR and OLR groups.

RESULTS

The analysis included 32 RLR and 386 OLR cases. After PSM, 29 RLR cases matched to 78 OLR cases. RLR had similar operative time, fewer blood loss (123 mL vs. 230 mL, P = 0.032), and shorter postoperative hospital stay (7.2 days vs. 10.4 days, P = 0.014) compared to OLR. RLR had similar incidence and grades of complications compared to OLR. No significant difference was found in recurrence-free and overall survival.

CONCLUSION

RLR after neoadjuvant therapy was as safe and feasible as OLR, and could improve postoperative recovery and produce equivalent long-term survival outcomes.