Adjuvant camrelizumab plus apatinib in resected hepatocellular carcinoma with microvascular invasion:a multi-center real world study  

作　　者：Jingzhong Ouyang Yi Yang Yanzhao Zhou Xu Chang Zhengzheng Wang Qingjun Li Yu Tang Jianqiang Cai Jinxue Zhou Zhen Huang Hong Zhao 

机构地区：[1]Department of Hepatobiliary and Pancreatic Surgery,The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou,China [2]Department of Hepatobiliary Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [3]Key Laboratory of Gene Editing Screening and Research and Development(R&D)of Digestive System Tumor Drugs,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [4]Department of Interventional Therapy II,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,China [5]Clinical Trials Center,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第4期616-631,I0022-I0024,共19页肝胆外科与营养（英文）

基　　金：Henan Provincial Medical Science and Technology Research Project(LLRGJ20220191);Key Scientific Research Project of Colleges and Universities in Henan Province(23A320033);Henan Provincial Science and Technology Project(232102311080);National Natural Science Foundation of China(82141127);CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-I2M-C&T-B-057);National Key Research and Development Program of China(2023YFC3403800);e Natural Science Foundation of Shandong Province(ZR2020QH177).

摘　　要：Background:It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected patients.However,what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus far.The aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral(AL)and posterosuperior(PS)segments.Methods:In this international multicentre retrospective cohort study,laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score matching.The differential benefit of laparoscopy over open liver surgery,calculated using bootstrap sampling,was compared between AL and PS resections and expressed as a Delta of the differences.Results:After matching,3,040 AL and 2,336 PS resections were compared,encompassing open and laparoscopic procedures in a 1:1 ratio.AL and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss,transfusion rate,complications,and length of stay.However,AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications(D-difference were 4.8%,P=0.046 and 3%,P=0.046)and blood loss(D-difference was 195 mL,P<0.001).Similar results were observed in the subset for high-volume centres,while in recent years no significant differences were found in the differential benefit between AL and PS segments.Conclusions:The advantage of laparoscopic over open liver surgery is greater in the AL segments than in the PS segments.

关 键 词：Liver neoplasms HEPATECTOMY laparoscopic liver resection open liver resection 

分 类 号：R735.7[医药卫生—肿瘤]