Title: Habib<i>TM</i> 4X-assisted resection versus clamp-crush resection for hepatocellular carcinoma: a propensity-matching study
Abstract: // Jiliang Qiu 1,* , Weiqun Lu 1,* , Nanrong Yu 1 , Guohua Yang 1 , Yi Li 2 , Zhiliang Huang 1 , Jianchang Li 1 , Kefei Li 1 , Houwei Xu 1 , Shicai Chen 1 , Xiang Zeng 1 and Haiying Liu 1 1 Department of Abdominal Oncosurgery, Cancer Center of Guangzhou Medical University, Guangzhou, China 2 Department of Surgery, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China * These authors have contributed equally to this paper Correspondence to: Haiying Liu, email: // Keywords : hepatocellular carcinoma, hepatic resection, Habib TM 4X, clamp-crush, complication Received : July 13, 2016 Accepted : December 01, 2016 Published : December 11, 2016 Abstract Long term outcome of ablation-assisted hepatic resection is unclear for hepatocellular carcinoma (HCC) patients. This study was scheduled to compare the outcome of Habib 4X ablation assisted resection (Habib group) with clamp-crush resection (CC group) for HCC. In this study, we retrospectively enrolled 81 patients from the Habib group and 103 patients from the CC group. Oncologic outcomes were analyzed using a propensity score matching (PSM) method. Compared with the CC group, the Habib group had higher levels of γ-glutamyltransferase ( P =0.044) and albumin ( P =0.001), larger tumor sizes ( P =0.007), shorter operation times ( P =0.001), less blood loss ( P =0.005), and less blood transfusions ( P =0.038). There were no significant differences in complications ( P =0.310), recurrence-free survival rates (RFS, P =0.112), or overall survival rates (OS, P =0.203) between the two groups. For the 67 patient pairs selected from the PSM analysis, the Habib group had better RFS and OS ( P =0.033 and P =0.014, respectively). A Cox proportional hazards analysis revealed that Habib-assisted resection was an independent factor for RFS and OS ( P =0.008 and P =0.016, respectively). Furthermore, for the 42 patients with central and large tumors, the Habib group had better RFS and OS than the CC group ( P =0.035 and P =0.038, respectively). However, the differences of RFS and OS ( P =0.117 and P =0.126, respectively) were not significant among 92 patients with peripheral or small tumors. Hence, Habib TM 4X-assisted resection is safe and provides better survival for HCC patients, particularly those with central and large tumors.