Perioperative and long-term outcomes of laparoscopic liver resection for combined hepatocellular carcinoma and cholangiocarcinoma versus intrahepatic cholangiocarcinoma: A propensity score matching analysis.

Background: Laparoscopic liver resection (LLR) has been increasingly used to treat intrahepatic cholangiocarcinoma (ICC), yet the role of LLR on combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) remains unclear. The purpose of this study was to compare the perioperative efficacy and long-term prognosis of LLR for cHCC-CC and ICC through the use of propensity score matching (PSM) analysis.

Methods: Clinicopathologic, perioperative, and survival data of patients with cHCC-CC and ICC who underwent LLR from November 2018 to May 2023 at our institution were retrospectively collected. The two groups were further analyzed using 1:1 PSM to compare perioperative outcomes and long-term prognosis.

Results: A total of 115 patients who underwent LLR for either eHCC-CC or ICC were ultimately included in the study. Among them, there were 24 cases in the cHCC-CC group and 91 cases in the ICC group. After PSM, the cHCC-CC group exhibited a significantly higher prevalence of preoperative elevated AFP levels (45.8% vs. 0, P < 0.001) compared with the ICC group. The two groups were comparable in terms of perioperative data. After a median follow-up of 34 months, there were no significant difference in 1-year OS (92% vs. 88%), 2-year OS (62% vs. 70%), 3-year OS (49% vs. 59%), 1-year RFS (46% vs. 58%), 2-year RFS (29% vs. 54%), 3-year RFS (29% vs. 42%) between the cHCC-CC and ICC groups (all P > 0.05).

Conclusions: The perioperative outcomes and long-term prognosis of LLR for patients with cHCC-CC are comparable to those observed in patients with ICC.